Issue release date: 26.09.2025
2Albert Einstein Hospital, Department of Neurosurgery, São Paulo - São Paulo (SP), Brazil DOI : 10.5137/1019-5149.JTN.46950-24.4 AIM: To systematically evaluate the existing literature regarding adjuvant or primary treatment of chronic subdural hematoma (cSDH) with tranexamic acid (TXA).
MATERIAL and METHODS: This systematic review followed the parameters set by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A search in the available literature was conducted up to February 2024 in five databases using the keywords ?chronic subdural hematoma? and ?tranexamic acid.? Randomized clinical trials, prospective or retrospective cohorts, systematic reviews, and case series (> five patients) relevant to the analysis were included.
RESULTS: In total, 10 studies were included, encompassing a total of 912 patients diagnosed with cSDH who underwent treatment with TXA. Seven studies evaluated the use of TXA as an adjunctive to surgical treatment, and three articles investigated the effect of TXA as primary therapy.
CONCLUSION: TXA can be considered a safe and effective option in adjunct to surgical management. Further studies are needed to establish its role as primary treatment.
Keywords : Tranexamic acid, Chronic subdural hematoma, Systematic review