Clinical Efficacy and Safety of Atorvastatin for Chronic Subdural Hematoma: A Randomized Controlled Trial

The aim of the present investigation was to observe the efficacy and safety of atorvastatin on chronic subdural hematoma patients. A total of 58 chronic subdural hematoma patients were recruited in this study, randomly divided into the control group and the atorvastatin treatment group (2 patients withdrew; n=28 each group). Before and after 24 w of treatment, the clinical outcome in patients was evaluated. The activities of daily living and neurological deficit scoring standard scores were assessed at 4, 8, 12 and 24 w after treatment. Levels of clinical biochemical indicators, serum high-sensitivity C-reactive protein, interleukin 6, matrix metalloproteinase 9 and tumour necrosis factor α were presented. Furthermore, hematoma volume was detected, which was used to assess the speed and degree of hematoma absorption. The adverse reactions and recurrence rates were recorded. The total effective rate of the atorvastatin treatment group was significantly higher than that of the control group (p=0.024). Following treatment, the activities of daily living score (98.3±9.64) of the treatment group was significantly higher than that of the control group (83.8±6.85; p=0.013). Moreover, the neurological deficit scoring standard score (13.8±3.89) of the atorvastatin-treated group was distinctly lower than that of the control group (20.1±4.67; p=0.021). On w 24 of treatment, compared to the control group, the serum high-sensitivity C-reactive protein, interleukin 6, matrix metalloproteinase 9 and tumour necrosis factor α levels in the treatment group were significantly reduced. Hematoma volume of the treatment group was significantly absorbed compared to the control group (p=0.008). There was no statistical significance in the incidence of various adverse reactions between the two groups. The recurrence rate of the control group (3.60 %) was significantly higher than that of the atorvastatin treatment group (25.00 %; p<0.05). These findings demonstrated that atorvastatin could reduce inflammatory response, promote hematoma absorption, protect neurological status and reduce the recrudescence rate for patients with chronic subdural hematoma.