Pathological Mechanisms and Therapeutic Optimization of Recurrent Chronic Subdural Hematoma

慢性硬膜下血肿(CSDH)是神经外科常见疾病，有极高的复发率，其复发机制与炎症反应、血管新生及凝血–纤溶失衡密切相关。目前钻孔引流术联合脑膜中动脉栓塞可有效降低复发率，药物治疗中阿托伐他汀联合地塞米松通过抗炎与抑制血管生成发挥协同作用。本文系统综述CSDH复发的病理机制与临床防治策略，强调优化手术技术、精准药物干预及个体化术后管理的重要性，为临床实践提供循证依据。Chronic Subdural Hematoma (CSDH) is a common neurosurgical disease with a high recurrence rate. Its recurrence mechanism is closely associated with inflammatory response, angiogenesis, and coagulation-fibrinolysis imbalance. Currently, burr hole drainage combined with middle meningeal artery embolization can effectively reduce the recurrence rate. In drug therapy, atorvastatin combined with dexamethasone exerts a synergistic effect by suppressing inflammation and inhibiting angiogenesis. This article systematically reviews the pathological mechanisms and clinical prevention/treatment strategies for CSDH recurrence, emphasizing the importance of optimizing surgical techniques, precise drug intervention, and individualized postoperative management to provide an evidence-based basis for clinical practice.