Treatment of Relapsed Chronic Subdural Hematoma in Four Young Children with Atorvastatin and Low-dose Dexamethasone
Treatment of Relapsed Chronic Subdural Hematoma in Four Young Children with Atorvastatin and Low-dose Dexamethasone
复制标题
阿托伐他汀联合小剂量地塞米松治疗四名幼儿复发性慢性硬膜下血肿
DOI：
10.1002/phar.2276
复制
发表时间：
2019-07-01
期刊：
影响因子：
4.1
通讯作者：
Jiang, Rongcai
中科院分区：
文献类型：
--
作者：
Huang, Jinhao;Li, Lihong;Jiang, Rongcai
在极少数情况下，儿童可能会出现慢性硬膜下血肿 (CSDH)。钻孔引流术（BHD）是首选治疗方法，但其复发率较高。本报告描述了四例 BHD 后复发性 CSDH 儿科患者（1-7 岁）的病例，他们成功接受了药物治疗方案，其中包括每天 2.5-5 mg 阿托伐他汀联合地塞米松，逐步减少剂量，总共 4 周。治疗4周后，3名患者的血肿完全消退，1名患者的血肿明显减少。治疗期间，没有患者报告有临床意义的不良事件。在长达4年的随访期间，没有患者出现血肿复发。本病例报告表明需要进行随机安慰剂对照试验来评估该药物治疗方案对复发性 CSDH 患者的非手术治疗。
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.