Systematic review of current randomised control trials in chronic subdural haematoma and proposal for an international collaborative approach

E Edlmann^{1

2}, D C Holl³, H F Lingsma⁴, J Bartek Jr^{5

6

7}, A Bartley⁸, J Duerinck⁹, T S R Jensen¹⁰, J Soleman¹¹, N C Shanbhag^{12

13}, B Indira Devi^{12

13}, T Laeke^{13

14}, A M Rubiano^{13

15}, K Fugleholm¹⁰, J van der Veken⁹, M Tisell⁸, P J Hutchinson^{16

13}, R Dammers³, A G Kolias^{16

13

17}; International Collaborative Research Initiative on Chronic Subdural Haematoma (iCORIC) study group

Collaborators, Affiliations

Collaborators

International Collaborative Research Initiative on Chronic Subdural Haematoma (iCORIC) study group:
E Edlmann, D C Holl, H F Lingsma, J Bartek Jr, A Bartley, J Duerinck, T S R Jensen, J Soleman, N C Shanbhag, B Indira Devi, T Laeke, A M Rubiano, K Fugleholm, J van der Veken, M Tisell, R Dammers, P J Hutchinson, A G Kolias, C Iorio-Morin, L Marshman, W Poon, V Smita, S Sousa, M N Stienen, Y Tian, N A van der Gaag, D Verbaan

Affiliations

¹ Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Box 167, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK. eedlmann@nhs.net.
² University Hospitals Plymouth NHS trust, Derriford Road, Plymouth, PL6 8DH, UK. eedlmann@nhs.net.
³ Department of Neurosurgery, Erasmus Medical Centre, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
⁴ Department of Public Health and Medical Decision Making, Erasmus MC Stroke Centre, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
⁵ Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
⁶ Department of Clinical Neuroscience and Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
⁷ Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
⁸ Department of Neurosurgery, Sahlgrenska University Hospital, Blå stråket 5, 41345, Gothenburg, Sweden.
⁹ Department of Neurosurgery, UZ Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
¹⁰ Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
¹¹ Department of Neurosurgery, University Hospital of Basel and University of Basel, Basel, Switzerland.
¹² Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India.
¹³ NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK.
¹⁴ Neurosurgery Unit, Addis Ababa University, School of Health Sciences, Addis Ababa, Ethiopia.
¹⁵ INUB/MEDITECH Research Group, El Bosque University, Bogotá, Colombia.
¹⁶ Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Box 167, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
¹⁷ Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

PMID: 32025806
DOI: 10.1007/s00701-020-04218-8

Systematic review of current randomised control trials in chronic subdural haematoma and proposal for an international collaborative approach

E Edlmann et al. Acta Neurochir (Wien). 2020 Apr.

. 2020 Apr;162(4):763-776.

doi: 10.1007/s00701-020-04218-8. Epub 2020 Feb 6.

Authors

Collaborators

International Collaborative Research Initiative on Chronic Subdural Haematoma (iCORIC) study group:
E Edlmann, D C Holl, H F Lingsma, J Bartek Jr, A Bartley, J Duerinck, T S R Jensen, J Soleman, N C Shanbhag, B Indira Devi, T Laeke, A M Rubiano, K Fugleholm, J van der Veken, M Tisell, R Dammers, P J Hutchinson, A G Kolias, C Iorio-Morin, L Marshman, W Poon, V Smita, S Sousa, M N Stienen, Y Tian, N A van der Gaag, D Verbaan

Affiliations

¹ Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Box 167, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK. eedlmann@nhs.net.
² University Hospitals Plymouth NHS trust, Derriford Road, Plymouth, PL6 8DH, UK. eedlmann@nhs.net.
³ Department of Neurosurgery, Erasmus Medical Centre, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
⁴ Department of Public Health and Medical Decision Making, Erasmus MC Stroke Centre, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
⁵ Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
⁶ Department of Clinical Neuroscience and Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
⁷ Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
⁸ Department of Neurosurgery, Sahlgrenska University Hospital, Blå stråket 5, 41345, Gothenburg, Sweden.
⁹ Department of Neurosurgery, UZ Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
¹⁰ Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
¹¹ Department of Neurosurgery, University Hospital of Basel and University of Basel, Basel, Switzerland.
¹² Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India.
¹³ NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK.
¹⁴ Neurosurgery Unit, Addis Ababa University, School of Health Sciences, Addis Ababa, Ethiopia.
¹⁵ INUB/MEDITECH Research Group, El Bosque University, Bogotá, Colombia.
¹⁶ Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Box 167, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
¹⁷ Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

PMID: 32025806
DOI: 10.1007/s00701-020-04218-8

Abstract

Background: Chronic subdural haematoma (CSDH) is a pathology that is frequently encountered by neurosurgeons. Nevertheless, there is a lack of guidelines based on solid evidence. There has been a recent and considerable increase in the interest on management and outcomes for CSDH. Therefore, we systematically reviewed all currently running randomised controlled trials (RCTs) in chronic subdural haematoma to understand the areas under investigation and plan future collaborative trials.

Methods: Clinical trials databases (Cochrane Controlled Register of Trials, WHO ICTRP and clinical trials.gov) were searched for trials relevant to chronic subdural haematoma. It was then established which trials were currently running and fulfilled robust research methodology for a RCT.

Results: There are 26 currently running RCTs in CSDH, with the most common topics covering application of steroids (7), surgical techniques (5) and tranexamic acid (5). Further to this, there are trials running on other pharmacological agents (4), middle meningeal artery (MMA) embolisation (2) and peri-operative management (3).

Conclusions: Pharmacological agents are a particular focus of CSDH management currently, and a wealth of studies on steroids will hopefully lead to more harmonised, evidence-based practice regarding this in the near future. Surgical techniques and new procedures such as MMA embolisation are also important focuses for improving patient outcomes. There is an on-going need for future RCTs and evidence-based guidelines in CSDH, particularly including low- and middle-income countries, and it is hoped that the establishment of the iCORIC (International COllaborative Research Initiative on Chronic Subdural Haematoma) will help address this.

Keywords: Chronic subdural haematoma; Collaboration; Elderly; Head injury; Trials.

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References

1. Almenawer SA, Farrokhyar F, Hong C, Alhazzani W, Manoranjan B, Yarascavitch B, Arjmand P, Baronia B, Reddy K, Murty N, Singh S (2014) Chronic subdural hematoma management: a systematic review and meta-analysis of 34,829 patients. Ann Surg 259:449–457 - DOI
1. Australian New Zealand Clinical Trials Registry: Sydney (NSW); NHMRC Clinical Trials Centre, University of Sydney (Australia). Identifier ACTRN12613000175774 A study to compare surgery for chronic subdural haematoma with and without corticosteroids. http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12613000175774 . September 25, 2019
1. Bartley A, Jakola AS, Bartek J Jr, Sundblom J, Forander P, Marklund N, Tisell M (2017) The Swedish study of Irrigation-fluid temperature in the evacuation of Chronic subdural hematoma (SIC!): study protocol for a multicenter randomized controlled trial. Trials 18:471 - DOI
1. Bender MB, Christoff N (1974) Nonsurgical treatment of subdural hematomas. Arch Neurol 31:73–79 - DOI
1. Brennan PM, Kolias AG, Joannides AJ, Shapey J, Marcus HJ, Gregson BA, Grover PJ, Hutchinson PJ, Coulter IC, British Neurosurgical Trainee Research C (2017) The management and outcome for patients with chronic subdural hematoma: a prospective, multicenter, observational cohort study in the United Kingdom. J Neurosurg 127:732–739 - DOI

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Systematic review of current randomised control trials in chronic subdural haematoma and proposal for an international collaborative approach

Collaborators

Affiliations

Systematic review of current randomised control trials in chronic subdural haematoma and proposal for an international collaborative approach

Authors

Collaborators

Affiliations

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources