Low Intracranial Pressure Treatment Strategies for Chronic Subdural Hematoma Patients

• low intracranial pressure strategy treatment (Behavioral): 1. Supine position for 16h-18h daily, with head toward the affected side in most of the time, and 15-20 cm elevation of lower limbs. 2. Abdominal belt compression
• Atorvastatin plus Dexamethasone (Drug): Atorvastatin plus Dexamethasone

Primary outcomes

• subdural hematoma volume [three months]: difference of hematoma volume in subdura between two groups
• Markwalder scale [three months]: difference of Markwalder scale between two groups;The Markwalder Scale is designed to measure the chronic subdural hematoma scale. This scale is categorized into four grade. Grade 0 denots the patient neurologically normal, whereas grade 4, the highest grade, denotes the worst neuological assessment.
• Modified Rankin Scale [three months]: difference of Modified Rankin Scale between two groups; The modified Rankin Scale is a commonly used scale for measuring the degree of disability or dependence in the daily activities of people who have suffered a neurological disability. The scale runs from 0-6, running from perfect health without symptoms to death.
• Extended Glasgow Outcome score [three months]: difference of Extended Glasgow Outcome score between two groups; This score is used to measure the outcome after neurological disease. It defines 5 categories of possible outcomes after a brain injury, which is from good recovery(5) to death(1).

Sex: All, ages: 14 Years to any

Inclusion Criteria:

* patients above 14 yrs with chronic subdural hematoma confirmed by cranial imaging;
* patients with MGS-GCS score ≤1 point, showing no signs of neurological deficits caused by CSDH or characteristics of high intracranial pressure;
* patients with MGS-GCS score ≥1 point, but with medication history of anticoagulant or antiplatelet drugs, coagulation dysfunction so that they are unsuitable or intolerant of surgery although they are in stable condition;
* patients who are unwilling to operate when they have no life-threatening brain herniation or no indications for emergency surgery, which confirmed by two neurosurgeons

Exclusion Criteria:

* women pregnant or in lactation
* those who are allergic to atorvastatin, hypoxamethasone;
* patients with brain herniation or altered mental status;
* patients with primary diseases like tumors, hemorrhagic diseases or some other critically serious conditions( eg.multiple organ failure);
* patients with uncontrollable diabetes and heart failure
* patients with preexisting chronic abdominal diseases (such as inflammatory bowel disease) or lung tumors or digestive system neoplasm
* Patients with abnormal liver function
* patients had taken atorvastatin or dexamethasone, ACEI in the past one week
* other conditions not eligible to enroll the trial confirmed by two individual doctor