The Outcome of Medical Management of Chronic Subdural Hematoma with Tranexamic Acid - A Prospective Observational Study.

INTRODUCTION: The conservative management of Chronic subdural hematoma (CSDH) is controversial. Many drugs have been tried in the conservative management of CSDH. Tranexamic acid (Txa) is one such drug in the armamentarium for conservative management of CSDH. We conducted a prospective observational study about treatment of CSDH with Txa.

MATERIAL AND METHODS: The study was conducted over three years. The clinical grading was assessed by the Markwalder grading system. All patients who were relatively and mildly symptomatic and willing for conservative management were recruited for the study. All patients were given Txa in the dosage of 750 mg/day in divided doses. The patients were followed up in the neurosurgery out-patient department.

RESULTS: There were 27 patients with 30 CSDH during this period who were treated with Txa. There were 20 cases of primary CSDHs and 7 cases of recurrent CSDHs following surgery that were enrolled in the Txa group. The mean volume of treated CSDH was 135.62 ± 92.90 SD. The mean thickness of CSDH enrolled in the study was 14.31 ± 5.47 SD. The mean number of days the patients treated with Txa was 64.83 ± 24.8 SD. There were no complications in any of the patients. All patients had good resolution of the hematomas, and none of the hematomas progressed during conservative treatment.

CONCLUSION: The conservative management of CSDH with Txa is both a safe and effective alternative in the absence of life-threatening symptoms.