PUBLICATIONS
On chronic subdural hematoma
General Publications by iCORIC
Study Protocol on Defining Core Outcomes and Data Elements in Chronic Subdural Haematoma
Conclusions: This study aims to define a standardized Core Outcome Set for reporting in all future CSDH studies; and second, to identify a unified CSDH Definition and set of baseline Data Elements for reporting in future CSDH studies. The overall study design includes a Delphi survey among Healthcare professionals or researchers and patients or carers. It is expected that the COS, definition, and DE will be developed through this Delphi survey and that these can be applied in future CSDH studies. This is necessary to help align future research studies on CSDH and to understand the effects of different treatments on patient function and recovery.
Dana C Holl, MSc, Aswin Chari, MRCS, Christian Iorio-Morin, PhD, FRCS, Ruben Dammers, PhD, Niels A van der Gaag, PhD, Angelos G Kolias, PhD, FRCS (SN), Peter J Hutchinson, PhD, FRCS (SN), Ellie Edlmann, PhD on behalf of the CODE-CSDH Advisory Group.
Neurosurgery, Volume 89, Issue 4, October 2021, Pages 720–725, https://doi.org/10.1093/neuros/nyab268.
Systematic review of current randomised control trials in chronic subdural haematoma and proposal for an international collaborative approach.
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.
Edlmann E, Holl DC, Lingsma HF, Bartek J Jr, Bartley A, Duerinck J, Jensen TSR, Soleman J, Shanbhag NC, Devi BI, Laeke T, Rubiano AM, Fugleholm K, van der Veken J, Tisell M, Hutchinson PJ, Dammers R, Kolias AG; International Collaborative Research Initiative on Chronic Subdural Haematoma (iCORIC) study group.
Acta Neurochirurgica (Wien). 2020 Apr;162(4):763-776. doi: 10.1007/s00701-020-04218-8. PMID: 32025806.
Prospective trial results: Publications by iCORIC-members
Conclusions: Burr hole craniostomy, minicraniotomy, and twist drill craniostomy are effective at treating patients with CSDH with eventual 6-month outcome being similar. Although not reaching statistical significance in our study, burr hole craniostomy offers the lowest recurrence rate combined with manageable complication rate.
Johnny Duerinck, Jorn Van Der Veken, Sophie Schuind, Frank Van Calenbergh, Johannes van Loon, Stephanie Du Four, Servaes Debacker, Emmanuel Costa, Christian Raftopoulos, Olivier De Witte, Wilfried Cools, Ronald Buyl, Vera Van Velthoven, Jean D’Haens, Michaël Bruneau,
Neurosurgery. 2022 May 24. Online ahead of print. PMID: 35593710.
Dex-CSDH trial - United Kingdom
Trial of Dexamethasone for Chronic Subdural Hematoma.
Conclusions: Among adults with symptomatic chronic subdural hematoma, most of whom had undergone surgery to remove their hematomas during the index admission, treatment with dexamethasone resulted in fewer favorable outcomes and more adverse events than placebo at 6 months, but fewer repeat operations were performed in the dexamethasone group.
Hutchinson PJ, Edlmann E, Bulters D, Zolnourian A, Holton P, Suttner N, Agyemang K, Thomson S, Anderson IA, Al-Tamimi YZ, Henderson D, Whitfield PC, Gherle M, Brennan PM, Allison A, Thelin EP, Tarantino S, Pantaleo B, Caldwell K, Davis-Wilkie C, Mee H, Warburton EA, Barton G, Chari A, Marcus HJ, King AT, Belli A, Myint PK, Wilkinson I, Santarius T, Turner C, Bond S, Kolias AG; British Neurosurgical Trainee Research Collaborative; Dex-CSDH Trial Collaborators.
New England Journal of Medicine. 2020 Dec 31;383(27):2616-2627. doi: 10.1056/NEJMoa2020473. Epub 2020 Dec 16. PMID: 33326713.
Corticosteroids as an Adjuvant Treatment to Surgery in Chronic Subdural Hematomas: A Multi-Center Double-Blind Randomized Placebo-Controlled Trial.
Conclusions: The HEMACORT trial data suggest that prednisone, as an adjuvant treatment to surgery, may reduce early radiological recurrence of CSDH, although clinical benefits are unclear. In view of these findings, the authors suggest that shorter treatment duration should be assessed for safety and efficacy in future trials.
Sam Ng, Julien Boetto, Héléna Huguet, Pierre-Hugues Roche, Stéphane Fuentes, Michel Lonjon, Stéphane Litrico, Anne-Marie Barbanel, Pascal Sabatier, Luc Bauchet, Hugues Chevassus, Nicolas Lonjon, on behalf of the HEMACORT Study Group.
Journal of Neurotrauma. 28 Apr 2021. https://doi.org/10.1089/neu.2020.7560