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Treatment of Relapsed Chronic Subdural Hematoma in Four Young Children with Atorvastatin and Low-dose Dexamethasone |
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| Authors: | Jinhao Huang Lihong Li Jingyi Zhang Chuang Gao Wei Quan Ye Tian Jian Sun Qilong Tian Dong Wang Jingfei Dong Jianning Zhang Rongcai Jiang |
| Affiliation: | 1. Department of Neurosurgery, Yangquan 1st People's Hospital, Yangquan, China;2. Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Tianjin Medical University General Hospital, Ministry of Education, Tianjin, China;3. Department of Neurosurgery, Tangdu Hospital, Army Military University, Xian, China;4. Division of Hematology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington;5. Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China |
| Abstract: | Chronic subdural hematoma (CSDH) can develop in children in rare cases. Burr-hole drainage (BHD) is the treatment of choice, but it is associated with a high rate of recurrence. This report describes four cases of pediatric patients (1–7 yrs of age) with post-BHD relapsed CSDH who were successfully treated with a drug regimen that included 2.5–5 mg atorvastatin daily combined with dexamethasone with stepwise-decreasing dosing for a total of 4 weeks. After 4 weeks of treatment, the hematoma was completely resolved in three patients and significantly reduced in one patient. During the treatment, no patient reported clinically significant adverse events. No patient experienced hematoma relapse during the follow-up period that lasted for up to 4 years. This case report suggests the need for a randomized placebo-controlled trial to evaluate this drug regimen for nonsurgical treatment of patients with relapsed CSDH. |
| Keywords: | chronic subdural hematoma child atorvastatin dexamethasone |