A Case Report of Recurrent Chronic Subdural Hematoma Successfully Treated with Jidabokuippo

Abstract

We report a case of recurrent chronic subdural hematoma (CSDH) successfully treated with jidabokuippo. The patient was an 81 year-old woman who was performed burr hole surgery for left CSDH. Residual hematoma was gradually increased in postoperative serial brain CT. Although goreisan and saireito were administrated to prevent recurrence, the treatment was not effective. Thereafter, reoperation was performed because of the appearance of aphasia and right hemiparesis. Intraoperative findings revealed that the hematoma was viscous and was not enough drained. Since there was little improvement in clinical and CT findings, a phenomenon of the hematoma was considered as oketsu and jidabokuippo was administrated. Three weeks after the medication, right hemiparesis was improved. Seven weeks after the medication, the hematoma was markedly reduced. Taken together, these results strongly suggest that jidabokuippo is effective for postoperative recurrent CSDH which is difficult for drainage and has no response to the administration of goreisan and saireito.