Subdural Instillation of a Thrombolytic Agent for Treatment of Recurrent Subdural Hematoma

• Published in: Clinical neuropharmacology Vol. 40; no. 6; pp. 279 - 280
• Main Authors: Frenkel, Mark B, Sarwal, Aarti, Wren, Mary Petrulis, Newey, Christopher R, Couture, Daniel E
• Format: Journal Article
• Language: English
• Published: United States 01-11-2017
• Subjects: Aged, 80 and over; Fibrinolytic Agents - administration & dosage; Hematoma, Subdural, Chronic - diagnostic imaging; Hematoma, Subdural, Chronic - drug therapy; Humans; Male; Recurrence; Subdural Space - diagnostic imaging; Subdural Space - drug effects; Treatment Outcome
• ISSN: 0362-5664; 1537-162X
• DOI: 10.1097/WNF.0000000000000247

This study aims to report the case of a patient with recurrent subdural hemorrhage (SDH) who was administered tissue plasminogen activator through a subdural drain to enhance drainage and prevent recurrence.
An 85-year-old man was treated for subacute over chronic SDH that kept on reaccumulating despite serial twist drill drainage, burr hole drainage, and craniotomy. No coagulopathy was identified with adequate blood pressure control.
Treatment with tissue plasminogen activator resulted in successful drainage of the SDH, and the patient had no further recurrence at 9-month follow-up.