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Subject Area

Neurosurgery

Article Type

Original Study

Abstract

Background: Chronic subdural hematoma (CSDH) is one of the most common problems in neurosurgery, especially in elderly patients. The surgery is the standard method of treatment for CSDH as it is relatively safe. On the other side the relatively high recurrence rate and the morbidity and morbidity are not negligible. The conservative treatment of CSDH can only be considered in selected cases. The most common and potent drug that helps in angiogenesis without risk of hematoma is atorvastatin. Methods: A single-center retrospective study was carried out on 17 patients with CSDH who refuse surgical treatment or who are unfit for surgery at Menoufia University Hospitals during January 2017 to January 2022. Complete neurological examination and conscious level assessment using Galscow Coma Scale and computerized topography brain were assessed to all studied patients. Results: Most of CSDH patients had hypodensity (58.82%), followed by mixed density (31.3%). Also, headache was the main clinical manifestation among CSDH patients found in 14 patients (82.35%). However, Mean GCS, hematoma MLS, hematoma max thickness and hematoma volume were significantly improved after treatment hematoma with atorvastatin, with mean changes 0.56±0.63 (95%CI, -0.90-(-0.23); 2.38±1.26(95%CI, 1.7-3.05, p=0.003); 9.06±4.48(95%CI,6.68-11.45, p0.05). Conclusions: Atorvastatin can be considered as an effective conservative treatment of mild or moderate CSDH treatment in patients with high risk of anesthesia or refuse surgery with no observed side effects.

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