Resolution of Chronic Subdural Hematoma after Treatment with Tumor Necrosis Factor Alpha Inhibitor

DOI: 10.4236/nm.2011.24045   PDF   HTML   XML   6,389 Downloads   10,581 Views   Citations


Background and Importance: Chronic subdural hematomas (cSDH) are a common problem for which solutions remain imperfect. Surgery is effective, but not without risk. Recent data have suggested a role for inflammation in the genesis of cSDH and several reports have documented some benefit to steroid treatment. In this report, a possible role for tumor necrosis factor alpha blockade in the resolution of a multiply recurrent cSDH is described. Clinical Presentation: An 86-year-old man with rheumatoid arthritis treated with infliximab presented with a large, symptomatic, multiloculated cSDH. Infliximab was withheld and craniotomy for evacuation was uncomplicated, but recurrent symptoms were noted and a recurrence was operated upon again several weeks later. Follow up CT showed a second recurrence. The patient requested to go back on his infliximab due to painful arthralgias. After a single dose of 10 mg/kg, follow up CT showed that the cSDH resolved and did not recur. Conclusion: Anti-TNF-alpha treatment with infliximab may have played a role in the resolution of this patient’s cSDH. Further investigation of this possible effect seems warranted.

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D. Ross, "Resolution of Chronic Subdural Hematoma after Treatment with Tumor Necrosis Factor Alpha Inhibitor," Neuroscience and Medicine, Vol. 2 No. 4, 2011, pp. 347-350. doi: 10.4236/nm.2011.24045.

Conflicts of Interest

The authors declare no conflicts of interest.


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