Efficacy of atorvastatin-based treatment in super-aged patients with chronic subdural hematoma: a case series and literature review
BackgroundChronic subdural hematoma (CSDH) is a common neurological disorder in the elderly, typically managed through surgical intervention; however, in patients aged 90 years and older, surgery is often not feasible due to comorbidities, anticoagulant use, and other age-related factors. This study...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1609514/full |
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| author | Jiangyuan Yuan Wei Quan Xuanhui Liu Pan Li Jinhao Huang Chuang Gao Tao Liu Yongqiang Zhang Jianning Zhang Rongcai Jiang Rongcai Jiang |
| author_facet | Jiangyuan Yuan Wei Quan Xuanhui Liu Pan Li Jinhao Huang Chuang Gao Tao Liu Yongqiang Zhang Jianning Zhang Rongcai Jiang Rongcai Jiang |
| author_sort | Jiangyuan Yuan |
| collection | DOAJ |
| description | BackgroundChronic subdural hematoma (CSDH) is a common neurological disorder in the elderly, typically managed through surgical intervention; however, in patients aged 90 years and older, surgery is often not feasible due to comorbidities, anticoagulant use, and other age-related factors. This study evaluates the effects of atorvastatin, either as monotherapy or in combination with dexamethasone, in the conservative treatment of CSDH in patients over 90 years old, while also reviewing the current literature on the management of CSDH in this super-aged population.MethodsSeventeen super-aged patients diagnosed with CSDH at our neurosurgical department between January 2017 and June 2024, who either refused or were considered unsuitable for surgery, were included in the study. Six patients received atorvastatin monotherapy, while 11 were treated with a combination of atorvastatin and dexamethasone. Head imaging scans were analyzed, and the modified Rankin Scale (mRS) and Markwalder’s Grading Scale/Glasgow Coma Scale (MGS-GCS) scores were assessed before and after treatment.ResultsAt the six-month follow-up, all patients showed significant improvement in neurological symptoms, as reflected by lower mRS and MGS-GCS scores. Hematomas were completely absorbed in 10 patients, significantly reduced in five, and unchanged in two patients with calcified hematoma. Three patients developed hyperglycemia, and one patient exhibited transaminitis; these adverse effects were resolved following the discontinuation of dexamethasone and the use of hepatoprotective medications. No mortality was recorded during the six-month follow-up.ConclusionOur findings suggest that atorvastatin-based treatment may improve the prognosis of CSDH in super-aged patients and offer a viable therapeutic alternative for those ineligible for surgery. |
| format | Article |
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| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-5c2c3bf73452415b8a4f1a8510a6cff02025-08-20T03:31:48ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-06-011610.3389/fneur.2025.16095141609514Efficacy of atorvastatin-based treatment in super-aged patients with chronic subdural hematoma: a case series and literature reviewJiangyuan Yuan0Wei Quan1Xuanhui Liu2Pan Li3Jinhao Huang4Chuang Gao5Tao Liu6Yongqiang Zhang7Jianning Zhang8Rongcai Jiang9Rongcai Jiang10State Key Laboratory of Experimental Hematology, Laboratory of Post-Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin and Ministry of Education, Department of Neurosurgery, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, ChinaState Key Laboratory of Experimental Hematology, Laboratory of Post-Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin and Ministry of Education, Department of Neurosurgery, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, ChinaState Key Laboratory of Experimental Hematology, Laboratory of Post-Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin and Ministry of Education, Department of Neurosurgery, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Neurology, Tianjin Huanhu Hospital, Tianjin, ChinaState Key Laboratory of Experimental Hematology, Laboratory of Post-Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin and Ministry of Education, Department of Neurosurgery, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, ChinaState Key Laboratory of Experimental Hematology, Laboratory of Post-Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin and Ministry of Education, Department of Neurosurgery, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, ChinaState Key Laboratory of Experimental Hematology, Laboratory of Post-Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin and Ministry of Education, Department of Neurosurgery, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Geriatrics, Geriatric Ward of Neurology, Institute of Tianjin Geriatrics, Tianjin Medical University General Hospital, Tianjin, ChinaState Key Laboratory of Experimental Hematology, Laboratory of Post-Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin and Ministry of Education, Department of Neurosurgery, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, ChinaState Key Laboratory of Experimental Hematology, Laboratory of Post-Neuroinjury Neurorepair and Regeneration in Central Nervous System Tianjin and Ministry of Education, Department of Neurosurgery, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaBackgroundChronic subdural hematoma (CSDH) is a common neurological disorder in the elderly, typically managed through surgical intervention; however, in patients aged 90 years and older, surgery is often not feasible due to comorbidities, anticoagulant use, and other age-related factors. This study evaluates the effects of atorvastatin, either as monotherapy or in combination with dexamethasone, in the conservative treatment of CSDH in patients over 90 years old, while also reviewing the current literature on the management of CSDH in this super-aged population.MethodsSeventeen super-aged patients diagnosed with CSDH at our neurosurgical department between January 2017 and June 2024, who either refused or were considered unsuitable for surgery, were included in the study. Six patients received atorvastatin monotherapy, while 11 were treated with a combination of atorvastatin and dexamethasone. Head imaging scans were analyzed, and the modified Rankin Scale (mRS) and Markwalder’s Grading Scale/Glasgow Coma Scale (MGS-GCS) scores were assessed before and after treatment.ResultsAt the six-month follow-up, all patients showed significant improvement in neurological symptoms, as reflected by lower mRS and MGS-GCS scores. Hematomas were completely absorbed in 10 patients, significantly reduced in five, and unchanged in two patients with calcified hematoma. Three patients developed hyperglycemia, and one patient exhibited transaminitis; these adverse effects were resolved following the discontinuation of dexamethasone and the use of hepatoprotective medications. No mortality was recorded during the six-month follow-up.ConclusionOur findings suggest that atorvastatin-based treatment may improve the prognosis of CSDH in super-aged patients and offer a viable therapeutic alternative for those ineligible for surgery.https://www.frontiersin.org/articles/10.3389/fneur.2025.1609514/fullchronic subdural hematomasuper-aged patientsatorvastatindexamethasonecase series |
| spellingShingle | Jiangyuan Yuan Wei Quan Xuanhui Liu Pan Li Jinhao Huang Chuang Gao Tao Liu Yongqiang Zhang Jianning Zhang Rongcai Jiang Rongcai Jiang Efficacy of atorvastatin-based treatment in super-aged patients with chronic subdural hematoma: a case series and literature review Frontiers in Neurology chronic subdural hematoma super-aged patients atorvastatin dexamethasone case series |
| title | Efficacy of atorvastatin-based treatment in super-aged patients with chronic subdural hematoma: a case series and literature review |
| title_full | Efficacy of atorvastatin-based treatment in super-aged patients with chronic subdural hematoma: a case series and literature review |
| title_fullStr | Efficacy of atorvastatin-based treatment in super-aged patients with chronic subdural hematoma: a case series and literature review |
| title_full_unstemmed | Efficacy of atorvastatin-based treatment in super-aged patients with chronic subdural hematoma: a case series and literature review |
| title_short | Efficacy of atorvastatin-based treatment in super-aged patients with chronic subdural hematoma: a case series and literature review |
| title_sort | efficacy of atorvastatin based treatment in super aged patients with chronic subdural hematoma a case series and literature review |
| topic | chronic subdural hematoma super-aged patients atorvastatin dexamethasone case series |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1609514/full |
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