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01-04-2020 | Atorvastatin | Review Article - Neurosurgery general

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

Authors: 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, P. J. Hutchinson, R. Dammers, A. G. Kolias, on behalf of the International Collaborative Research Initiative on Chronic Subdural Haematoma (iCORIC) study group

Published in: Acta Neurochirurgica | Issue 4/2020

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.

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Title: Systematic review of current randomised control trials in chronic subdural haematoma and proposal for an international collaborative approach
Authors: 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
P. J. Hutchinson
R. Dammers
A. G. Kolias
on behalf of the International Collaborative Research Initiative on Chronic Subdural Haematoma (iCORIC) study group
Publication date: 01-04-2020
Publisher: Springer Vienna
Keywords: Atorvastatin
Tranexamic Acid
Published in: Acta Neurochirurgica / Issue 4/2020
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-020-04218-8

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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