{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T23:37:04Z","timestamp":1777246624147,"version":"3.51.4"},"reference-count":15,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>In this paper the authors investigate whether shunt-treated patients with normal-pressure hydrocephalus receiving aspirin therapy are at increased risk of developing subdural hematoma (SDH).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Records from 80 consecutive patients who had undergone implantation of a cerebrospinal fluid shunt for the treatment of normal-pressure hydrocephalus were retrospectively reviewed.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Eleven cases of symptomatic SDH occurred, all among patients receiving aspirin or clopidogrel. The 5-year survival estimate was 0.3 (p &lt; 0.0001) for users of aspirin and the hazard ratio was 12.8 (95% CI 3.1\u201353).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Patients on an aspirin therapy regimen have a markedly increased risk of SDH after a shunt has been implanted for the treatment of normal-pressure hydrocephalus. Users of clopidogrel may have an even greater risk.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.11.jns14804","type":"journal-article","created":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T15:02:42Z","timestamp":1420210962000},"page":"423-426","source":"Crossref","is-referenced-by-count":15,"title":["Aspirin is associated with an increased risk of subdural hematoma in normal-pressure hydrocephalus patients following shunt implantation"],"prefix":"10.3171","volume":"123","author":[{"given":"Peter","family":"Birkeland","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Lauritsen","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Odense University Hospital; and"},{"name":"Institute of Clinical Research, University of Southern Denmark, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frantz Rom","family":"Poulsen","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Institute of Clinical Research, University of Southern Denmark, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns14804","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1016\/j.clineuro.2012.10.008","article-title":"Anticoagulation therapy a risk factor for the development of chronic subdural hematoma","volume":"115","author":"Aspegren","year":"2013"},{"key":"b2-jns14804","series-title":"Schweiz Arch Neurol Neurochir Psychiatr","first-page":"5","article-title":"Subdural hematoma secondary to CSF ventricular shunt","volume":"127","author":"Baldini","year":"1980"},{"key":"b3-jns14804","series-title":"Acta Neurol Scand","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1111\/j.1600-0404.2007.00982.x","article-title":"Prevalence of probable idiopathic normal pressure hydrocephalus in a Norwegian population","volume":"118","author":"Brean","year":"2008"},{"key":"b4-jns14804","series-title":"Acta Neurochir Suppl","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1007\/978-3-7091-0923-6_24","article-title":"What is the appropriate shunt system for normal pressure hydrocephalus?","volume":"113","author":"Chrissicopoulos","year":"2012"},{"key":"b5-jns14804","series-title":"J Stroke Cerebrovasc Dis","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1016\/j.jstrokecerebrovasdis.2013.01.007","article-title":"Aspirin therapy and risk of subdural hematoma: meta-analysis of randomized clinical trials","volume":"22","author":"Connolly","year":"2013"},{"key":"b6-jns14804","series-title":"PLoS ONE","doi-asserted-by":"publisher","first-page":"e68732","DOI":"10.1371\/journal.pone.0068732","article-title":"Antiplatelet\/anticoagulant agents and chronic subdural hematoma in the elderly","volume":"8","author":"De Bonis","year":"2013"},{"key":"b7-jns14804","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1227\/01.NEU.0000255349.71700.E1","article-title":"Evaluation and treatment of patients with suspected normal pressure hydrocephalus on long-term warfarin anticoagulation therapy","volume":"60","author":"Goodwin","year":"2007"},{"key":"b8-jns14804","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/j.clineuro.2011.10.006","article-title":"Shunt over-drainage after mild head trauma","volume":"114","author":"G\u00fcrer","year":"2012"},{"key":"b9-jns14804","series-title":"J Med Case Reports","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1186\/1752-1947-6-393","article-title":"Rapid resolution of an acute subdural hematoma by increasing the shunt valve pressure in a 63-year-old man with normal-pressure hydrocephalus with a ventriculoperitoneal shunt: a case report and literature review","volume":"6","author":"Hayes","year":"2012"},{"key":"b10-jns14804","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/0090-3019(91)90050-J","article-title":"Management with a programmable pressure valve of subdural hematomas caused by a ventriculoperitoneal shunt: case report","volume":"35","author":"Kamano","year":"1991"},{"key":"b11-jns14804","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1212\/WNL.20.6.534","article-title":"A simple constant-infusion manometric test for measurement of CSF absorption. 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