Regression of chronic subdural hematoma under antiplatelet treatment: An unusual case

Abstract

The surgical evacuation is considered as the first choice of treatment for symptomatic chronic subdural hematoma. Since anticoagulation is considered a risk factor and any ongoing anticoagulation treatment is ceased once the diagnosis is confirmed, the data regarding the course of these cases under ongoing anticoagulant treatment remains extremely limited. A 73-year-old female was given antiplatelet treatment for ischemic stroke for right hemiparesis and dysarthria despite an existing, but unrecognized chronic subdural hematoma. The hematoma was discovered after 4 weeks following antiplatelet treatment, but in a smaller volume. As routine practice, antiplatelet treatment was ceased, and the hematoma completely resolved within 2 weeks. This case demonstrates that some patients with chronic subdural hematoma for whom continuation of anticoagulation is essential, can be observed closely if hematoma volume is small, and no midline shift is present since spontaneous resolution may occur. © 2024 Ondokuz Mayis Universitesi. All rights reserved.