title: Recent changes in risk factors of chronic subdural hematoma.
abstract: OBJECTIVE
  Chronic subdural hematoma (CSDH) is a typical disease that is encountered frequently in neurosurgical practice. The medications which could cause coagulopathies were known as one of the risk factors of CSDH, such as anticoagulants (ACs) and antiplatelet agents (APs). Recently, the number of patients who are treated with ACs/APs is increasing, especially in the elderly population. With widespread use of these drugs, there is a need to study the changes in risk factors of CSDH patients.
  
  
  METHODS
  We retrospectively reviewed 290 CSDH patients who underwent surgery at our institute between 1996 and 2010. We classified them into three groups according to the time of presentation (Group A : the remote period group, 1996-2000, Group B : the past period group, 2001-2005, and Group C : the recent period group, 2006-2010). Also, we performed the comparative analysis of independent risk factors between three groups.
  
  
  RESULTS
  Among the 290 patients, Group A included 71 patients (24.5%), Group B included 98 patients (33.8%) and Group C included 121 patients (41.7%). Three patients (4.2%) in Group A had a history of receiving ACs/APs, 8 patients (8.2%) in Group B, and 19 patients (15.7%) in Group C. Other factors such as head trauma, alcoholism, epilepsy, previous neurosurgery and underlying disease having bleeding tendency were also evaluated. In ACs/APs related cause of CSDH in Group C, significantly less proportion of the patients are associated with trauma or alcohol compared to the non-medication group.
  
  
  CONCLUSIONS
  In this study, the authors concluded that ACs/APs have more importance as a risk factor of CSDH in the recent period compared to the past. Therefore, doctors should prescribe these medications carefully balancing the potential risk and benefit.
authors.affiliation: Department of Neurosurgery, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Yang-Won
authors.initials: YW
authors.lastname: Sim
authors.forename: Kyung-Soo
authors.initials: KS
authors.lastname: Min
authors.forename: Mou-Seop
authors.initials: MS
authors.lastname: Lee
authors.forename: Young-Gyu
authors.initials: YG
authors.lastname: Kim
authors.forename: Dong-Ho
authors.initials: DH
authors.lastname: Kim
keywords: Anticoagulants; Antiplatelet agents; Chronic subdural hematoma; Risk factors