title: Atorvastatin May Attenuate Recurrence of Chronic Subdural Hematoma.
abstract: OBJECTIVE
  Chronic subdural hematoma (CSDH) is a common form of intracranial hemorrhage with a substantial recurrence rate. Atorvastatin may reduce CSDH via its anti-inflammatory and pro-angiogenesis effects, but its effectiveness for preventing recurrent CSDH has never been explored. We hypothesized that atorvastatin is effective in reducing recurrence of CSDH after surgery and identified determining factors predictive of hematoma recurrence.
  
  
  METHODS
  A prospective study was conducted in 168 surgical cases of CSDH.All patients were randomly assigned to the group treated with atorvastatin or control group. Clinically relevant data were compared between two groups, and subsequently between the recurrence and non-recurrence patients. Multiple logistic regression analysis of the relationship between atorvastatin treatment and the recurrence using brain atrophy, septated and bilateral hematoma was performed.
  
  
  RESULTS
  Atorvastatin group conferred an advantage by significantly decreasing the recurrence rate (P = 0.023), and patients managed with atorvastatin also had a longer time-to-recurrence (P = 0.038). Admission brain atrophy and bilateral hematoma differed significantly between the recurrence and non-recurrence patients (P = 0.047 and P = 0.045). The results of logistic regression analysis showed that atorvastatin significantly reduced the probability of recurrence; severe brain atrophy and bilateral hematoma were independent risk factors for recurrent CSDH.
  
  
  CONCLUSIONS
  Atorvastatin administration may decrease the risks of recurrence.Patients with severe brain atrophy and bilateral CSDH are prone to the recurrence.
authors.affiliation: Department of Neurosurgery, The First People's Hospital of Kunshan Affiliated with Jiangsu University Suzhou, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, The Affiliated Brain Hospital, Nanjing Medical University Nanjing, China.
authors.forename: Zhengxiang
authors.initials: Z
authors.lastname: Luo
authors.affiliation: Department of Neurosurgery, The People's Hospital of AnQiu City Weifang, China.
authors.forename: Zhongkun
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, The First People's Hospital of Kunshan Affiliated with Jiangsu University Suzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Rehabilitation Medicine, Shanghai Jiao Tong University Affiliated First People's Hospital Shanghai, China.
authors.forename: Shifeng
authors.initials: S
authors.lastname: Kan
keywords: Chronic subdural hematoma; atorvastatin; recurrence