Acute subdural hematoma (ASDH) is a common brain lesion that arises from painful brain injuries and is associated with high mortality and sickness. Emergency surgery is the most common intervention for these patients; However, in some cases, patients refuse to undergo surgery due to social, religious, economic or psychological reasons. In these cases, infections in ASDH SASDH, and non-surgical intervention should begin immediately. However, there is no consensus in the medical community how to treat these patients non-surgically. To address the issue, researchers from Capital Medical University, Beijing and Tianjin Medical University, Tianjin, China prescribed to evaluate the efficacy of a combination of drugs atorvastatin and dexamethasone in five patients reporting SASDH. The study was organized under the guidance of Professor Rongkai Jiang and published in the prestigious Chinese neurosurgeical journal On April 2, 2025.

The previous phase-II randomized proof-of-concept trial stated that the atorvastatin plus was effective in patients with cum-khurak dexamethasone chronic SDH. Based on this, Prof. Jiang explains the justification for his study “Given that sasdh and chronic SDH share extremely similar pathological and clinical characteristics, we guess that a low-dosage dexamethasone can be safe and effective for patients combined with dexamethasone, which is initially selecting non-nervous therapy”Four of the five patients were women, who were between 30 and 85 years of age. The male patient was a 97 -year -old, presented with cramps and atrial fibrillation. From hemophilia to rectal and bladder cancer, medical history of these patients was also diverse. Two female patients reported post-operative and post-ball SDH. All patients received an oral dose of 20 mg/day of atorvastatin with low -dose dexamethasone, where 2.25 mg/day in the first 2 weeks, 1.5 mg/day in the third week and 0.75 mg/day in the fourth week. After receiving this treatment of atorvastatin plus low-dexamethasone treatment, the symptoms of patients were significantly improved, in which there were no repetition or progress of symptoms even for subsequent treatment.

The authors discovered the next time research databases such as Pubmed and Google Scholars for literature about the protection and efficacy of non-surgical treatment and efficacy for patients with ASDH/SASDH. He submitted the results of these studies to record a total of 1374 patients with ASDH/SASDH, who received early non-surgical treatment. Of this, 13.1% of the symptoms were deteriorating in patients and had to undergo delayed surgical treatment. 19.2% of patients had a diagnosis of poor disease, 7% of patients were eventually dying. However, “More than 80% of patients did not require delayed surgery; it further suggests that in some cases in some cases with ASDH/SASDH, a good disease may be diagnosed with conservative treatment”Jiang Pro in Literature Survey conducted by the team. Jiang.

How Atorvastatin improves ASDH symptoms, its mechanism is still unclear. When mice are treated with atorvastatin with sasdh/asdh, a significant decrease in the levels of pro-inflammatory cytokines present in hematomas showed a significant decrease in the levels of cytokines, removing local inflammation, promoting the spread of blood vessels and promoting maturity and the absorption of SDH. In addition, this study stated that atorvastatin reverses edema in dural lymphatic vessels of the brain, restoration of damage in the membrane of blood vessels in the brain, rapidly promotes the discharge of hematoma.

The lack of an optimal non-surgical treatment for Sasdh inspired this study. The literature review suggested a high mortality rate of 7% for an immediate non-surgical treatment plan for these patients. The study, although it is conducted in a small local pool of patients with Sasdh, indicates that atorvastatin successfully resolves symptoms with low doses of dexamethasone and removes hematomus without recurrence during a six -month follow -up period.

overall, “The fruitless treatment strategy of Atorvastatin Plus dexamethasone is safe and effective. It is recommended to conduct further random-off-concept clinical trials to verify its efficacy.“Prof. Jiang concluded the study.