Chronic Subdural Hematoma and Tranexamic Acid: A Systematic Review.

Turkish neurosurgery Pub Date : 2025-01-01 DOI:10.5137/1019-5149.JTN.46950-24.4

Beatriz Rodrigues Messias, João Borges, Andre Felix Gentil

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Abstract

Aim: To systematically evaluate the existing literature regarding adjuvant or primary treatment of chronic subdural hematoma (cSDH) with tranexamic acid (TXA).

Material and methods: This systematic review followed the parameters set by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A search in the available literature was conducted up to February 2024 in five databases using the keywords ?chronic subdural hematoma? and ?tranexamic acid.? Randomized clinical trials, prospective or retrospective cohorts, systematic reviews, and case series ( > five patients) relevant to the analysis were included.

Results: In total, 10 studies were included, encompassing a total of 912 patients diagnosed with cSDH who underwent treatment with TXA. Seven studies evaluated the use of TXA as an adjunctive to surgical treatment, and three articles investigated the effect of TXA as primary therapy.

Conclusion: TXA can be considered a safe and effective option in adjunct to surgical management. Further studies are needed to establish its role as primary treatment.

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慢性硬膜下血肿与氨甲环酸：系统综述。

目的：慢性硬膜下血肿（cSDH）是一种患病率很高的神经外科病理，由于人口老龄化和抗凝药物的更多使用，预计在未来几十年发病率将增加。尽管手术治疗仍被认为是cSDH治疗的基石，但复发和手术发病率促使了对药物选择的研究。氨甲环酸（TXA）是一种公认的抗纤溶药物，临床上用于严重创伤和产后出血的控制。本研究旨在系统评价现有文献中关于用TXA辅助或主要治疗cSDH的研究。材料和方法：本系统评价遵循系统评价和荟萃分析首选报告项目（PRISMA）设置的参数。使用关键词“慢性硬膜下血肿”和“氨甲环酸”在五个数据库中检索了截至2024年2月的可用文献。纳入了与分析相关的随机临床试验、前瞻性或回顾性队列、系统评价和病例系列（5例患者）。结果：共纳入10项研究，共纳入912例诊断为cSDH并接受TXA治疗的患者。7项研究评估了TXA作为辅助手术治疗的使用，3篇文章调查了TXA作为主要治疗的效果。结论：TXA是一种安全有效的辅助手术治疗方法。需要进一步的研究来确定其作为初级治疗的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Turkish neurosurgery

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