Abstract
Abstract
Introduction. Chronic subdural hematoma (CSDH) is a frequent neurosurgical disease, which mainly affects elderly patients. Tranexamic acid (TXA) has been hypothesized as an oral agent to avoid CSDH progression and/or recurrence. We performed an evaluation to determine whether the postoperative use of TXA reduces recurrence rate.
Method. A prospective, randomized and controlled trial. Patients with unilateral or bilateral chronic subdural hematoma undergoing surgical treatment by burr-hole were randomized as to whether or not to use TXA in the postoperative period. We evaluated image and clinical recurrence of CSDH at follow up of 6 months and potential clinical and/or surgical complications impact of TXA.
Results. Twenty-six patients were then randomized to the control group (52%) and twenty-four patients to the TXA group (48%). Follow-up ranged from 3 months to 16 months. There were no significant difference between baseline data in groups regarding to age, gender, use of antiplatelet or anticoagulants, smoking, alcoholism, systemic arterial hypertension, diabetes mellitus, hematoma laterality, hematoma thickness and drain use. Clinical and radiological recurrence occurred in 3 patients (6%), being 2 cases in TXA group (8.3%) and 1 in control group (3.8%). Postoperative complications occurred in 2 patients during follow-up (4%), being both cases in TXA group (8.3%), and none in the control group.
Discussion and Conclusion. Although TXA group had a higher recurrence rate (8.3%), there was no statistically significant difference between the two groups. Moreover, TXA group had 2 complications while control group had no complications. Although limited by experimental nature of study and small sample, our current data suggest that TXA should not be used as a potential agent to avoid recurrences of CSDH and might increase complication odds.
Publisher
Research Square Platform LLC