Chronic Subdural Hematoma: Toward a New Management Paradigm for an Increasingly Complex Population

Journal of Neurotrauma
Christian Iorio-MorinDavid Mathieu

Abstract

Chronic subdural hematoma (cSDH) is a frequent yet poorly studied entity. Patients with cSDH are increasingly using antithrombotic medication, are now older, and present with a variety of clinical symptoms, including incidental discoveries. Despite this increasing complexity, management has remained roughly unchanged since the late 1990s. We review here the state of cSDH research under way at Université de Sherbrooke and around the world with a focus on studies addressing specific gaps in the current evidence base. We show that evidence is lacking at many decision points in the typical cSDH patient treatment algorithm. No definition of cSDH is universally accepted, and a formal definition project, along with suggested common data elements to be reported in future trials (CODE-CSDH: formal cSDH definition project) is ongoing. An amendment to International Statistical Classification of Diseases and Related Health Problems (ICD-11) has also been proposed to improve classification and registry research. Within the cSDH clinical assessment, evidence for the occurrence of nonepileptic, stereotypical, and intermittent symptoms (NESIS) is emerging. The GENESIS study (Generation Evidence on the etiology and management of NESIS) will tes...Continue Reading

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Citations

Mar 23, 2019·Journal of Neurosurgery·Minna RauhalaPauli Helén
Feb 7, 2020·Acta neurochirurgica·E EdlmannUNKNOWN International Collaborative Research Initiative on Chronic Subdural Haematoma (iCORIC) study group
Sep 11, 2020·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Chuan Jun HuangYu Zou
Jun 12, 2020·Acta neurochirurgica·Minna RauhalaTeemu M Luoto
Mar 9, 2020·Acta neurochirurgica·Minna RauhalaTeemu M Luoto
May 23, 2020·Journal of Neurointerventional Surgery·Eimad ShotarFrédéric Clarençon
Jul 8, 2020·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Mathieu LevesqueChristian Iorio-Morin

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Clinical Trials Mentioned

NCT02618382
NCT03353259
NCT03280212

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