Recent reports have shown that administration of
Gorei-san (Tsumura, Tokyo, Japan) can prevent recurrence of
chronic subdural hematoma (CSDH). However, no report has shown its potential, including its correlation with other recurrent clinical factors. We retrospectively evaluated the recurrent factors and the effects of
Gorei-san on CSDH using percutaneous subdural tapping. Between April 2009 and February 2012, we performed percutaneous subdural tapping on 160 patients with intact CSDH. Of this population, 125 patients with unilateral
hematoma and measurable initial
hematoma pressure were included in this study. From April 2010,
Gorei-san was routinely administered to patients. Patient characteristics such as age, sex, neurological grading, alcohol,
diabetes mellitus,
antiplatelet agent,
anticoagulant agent,
trauma, midline shift on CT images,
hematoma volume on CT images, initial
hematoma pressure, volume of the removed
hematoma, and administration of
Gorei-san were analyzed. Recurrence was recognized in 35/125 (28.0%) patients. Multivariate analysis revealed that a greater midline shift on CT images (p = 0.033) and initial
hematoma pressure (p = 0.031) predicted recurrence.
Gorei-san was administered to 94/125 (75.2%) patients, but they showed no changes in recurrence (27.7% vs. 29.0%; p = 1.0). Among 13 patients for whom
Gorei-san administration was started before surgery, CSDH recurrence was reported in only 1 (7.7%). However, the group showed a significantly lower number of recurrent factors. Patients with a greater midline shift in their CT images or higher initial
hematoma pressure need close postsurgical observation. The potential of
Gorei-san for preventing recurrence of CSDH needs further examination.