Successful Surgical Management of Chronic Subdural Hematoma in a Patient With Severe Thrombocytopenia due to Aplastic Anemia: A Case Report

ABSTRACT

This case report describes the successful surgical management of a chronic subdural hematoma (CSDH) in a 45‐year‐old male with severe aplastic anemia (AA) and severe thrombocytopenia. The patient presented with worsening headaches, and imaging confirmed a progressive CSDH with midline shift. Despite a platelet count of 22 × 10 ⁹ /L, preoperative transfusion increased it to 44 × 10 ⁹ /L, enabling a minimally invasive burr‐hole drainage procedure. Postoperative platelet support and atorvastatin therapy facilitated recovery, with imaging confirming hematoma evacuation and midline restoration. The case highlights the feasibility of neurosurgical intervention in severely thrombocytopenic patients through meticulous perioperative planning, including platelet management and minimally invasive techniques. It also underscores the potential role of atorvastatin in CSDH management, though further research is needed in thrombocytopenic populations. This report demonstrates that with careful perioperative planning, appropriate platelet support, and minimally invasive surgical technique, successful management of CSDH is achievable even in patients with severe thrombocytopenia secondary to AA.