Articles: hematoma.
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Statins have been reported to reduce the rates of recurrence and improve the resolution of chronic subdural hematomas (cSDHs) treated surgically or conservatively. No studies have investigated the effect of statins in patients treated with middle meningeal artery embolization. ⋯ Patients treated with middle meningeal artery embolization alone who were on statin therapy had no differences in cSDH resolution or recurrence compared to those who were not on statin therapy. It is possible that the anti-inflammatory effects of statins may not be relevant when supply to the dura is interrupted by treatment with embolization.
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Treatment of multiple recurrent chronic subdural hematomas (CSDH) is challenging. Identification of specific risk factors for multiple recurrences may allow a higher degree of personalized treatment, including closer postoperative follow-up, detailed prognostication, and a more aggressive initial surgical strategy, such as craniotomy, adjuvant embolization of the middle meningeal artery, or adjuvant medical treatment, such as steroids. The aim of this study was to identify pretreatment risk factors for a second recurrence of CSDH (re-re-CSDH) and risk factors for developing re-re-CSDH once operated for the first recurrence. ⋯ We found similar independent risk factors for re-CSDH and re-re-CSDH, and for re-re-CSDH once treated for re-CSDH. Hence, it was not possible to identify specific risk factors for patients at risk of re-re-CSDH at the time of the primary diagnosis.