| Use of Angiotensin Converting Enzyme Inhibitor Treatment in Reducing the Risk of Recurrence in Patients with Chronic Subdural Hematoma |
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Jin Seong Kim1 , In Sung Park1,2 , Jae-Hwan Chung1 , Dong-Ho Kang1, Soo-Hyun Hwang1 , Chul Hee Lee1 |
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1Department of Neurosurgery, Gyeongsang National University School of Medicine, Jinju,
2Institue of Health Sciences, Gyeongsang National University, Jinju, Korea |
| 만성 경막하 혈종 재발 방지에 있어 안지오텐신 전환 효소 억제제의 효과 |
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김진성1·박인성1,2·정재환1·강동호1·황수현1·이철희1 |
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경상대학교 의과대학 신경외과학교실1, 경상대학교 건강과학연구원2 |
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| Abstract |
Objective
The recurrence of hematoma is one of the major problems on the chronic subdural hematoma (CSDH). Neovascularization and plasma leakage from immature vessels are probably the primary source of the recurrence. Previous studies showed that the antiangiogenic adverse effect of angiotensin converting enzyme (ACE) inhibitor reduced the risk of recurrence of CSDH. This study aimed to evaluate the effects of ACE inhibitor on the recurrence of CSDH.
Methods
We retrospectively analyzed the data of patients with CSDH treated by a burr-hole trephination from January 2011 to December 2013. We consistently prescribed ACE inhibitor for patients with CSDH from January 2014. We retrospectively reviewed age, sex, pre- and postoperative computed tomography findings and the factors affect the recurrence.
Results
There were total 240 patients with CSDH treated by surgery from January 2011 to December 2013. From January 2014 to December 2014, 48 patients took ACE inhibitor after surgery more than 3 months. The recurrence rate was 0% in Group A (0 out of 48 patients) versus 8.0% in the Group B(21 out of 262 patients). There was no statistical difference of recurrence rate between two groups (p=0.067). None of the patients experienced significant side effects.
Conclusion
Using ACE inhibitor after burr-hole trephination seem to lower the risk of recurrence in CSDH. It is clinically safe and can be additional treatment option to the patients of CSDH for reducing recurrent rate. However, more extensive studies are needed to clarify the efficacy of use of ACE inhibitor for CSDH. |
| Key Words:
Angiotensin converting enzyme inhibitorㆍChronic subdural hematomaㆍRecurrence |
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