Evidence map›Paper›PMID 41196366›Full record

SynthesisActa neurochirurgica2025

Updated systematic review of current randomised controlled trials in chronic subdural haematoma.

R Fakhry, C Yesildal, J Bartek, J Duerinck, T S R Jensen, J Soleman, C Iorio-Morin, C M F Dirven, R Dammers, E Edlmann and 2 more

Abstract readSystematic Review
In one paragraph

Synthesis in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Pathophysiology of chronic subdural hematoma-new insights.Therapeutic advances in neurological disorders · 2026
    Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

R FakhryDepartment of Neurosurgery, Erasmus Medical Center, Erasmus MC Stroke Center, Rotterdam, the Netherlands. r.fakhry@erasmusmc.nl.
C YesildalDepartment of Neurosurgery, Erasmus Medical Center, Erasmus MC Stroke Center, Rotterdam, the Netherlands.
J BartekDepartment of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
J DuerinckDepartment of Neurosurgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
T S R JensenDepartment of Neurosurgery, Copenhagen University Hospital, Copenhagen, Denmark.
J SolemanDepartment of Neurosurgery, University Hospital Basel, Basel, Switzerland.
C Iorio-MorinDivision of Neurosurgery, Department of Surgery, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Canada.
C M F DirvenDepartment of Neurosurgery, Erasmus Medical Center, Erasmus MC Stroke Center, Rotterdam, the Netherlands.
R DammersDepartment of Neurosurgery, Erasmus Medical Center, Erasmus MC Stroke Center, Rotterdam, the Netherlands.
E EdlmannDepartment of Neurosurgery, South West Neurosurgical Centre, Plymouth, United Kingdom.
D C HollDepartment of Neurosurgery, Erasmus Medical Center, Erasmus MC Stroke Center, Rotterdam, the Netherlands.
on be half of the International Collaborative Research Initiative on Chronic Subdural Haematoma (iCORIC) study group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic subdural haematoma (CSDH) is a common neurosurgical condition with an increasing incidence due to an aging population. Given the expanding research landscape, assessing the state of recent trials is essential. This systematic review updates a previous review, which included randomised controlled trials (RCTs) up to 2019, by summarizing recently published and ongoing RCTs in CSDH, highlighting key areas of investigation and identifying directions for future research.

methodsClinical trial registries - including the Cochrane Controlled Register of Trials, WHO ICTRP, clinicaltrials.gov, and Clinical Trials Information System - were systematically searched for RCTs on CSDH from June 1, 2019, to February 18, 2025. Both published and ongoing trials were included in this review.

resultsThis review identified 41 recently published RCTs and 54 ongoing RCTs, compared to 26 ongoing trials in 2019. Of the earlier review, eleven studies have been published, five remain active, and the remainder were either abandoned or did not adhere to their initial RCT design. Middle meningeal artery embolisation (MMAE) has become the most extensively studied intervention, with active trials increasing from 2 in 2019 to 21 in 2025. Trials investigating perioperative management (3 versus 7) and surgical techniques (5 versus 10) have also increased. In contrast, corticosteroid trials have decreased (7 versus 3), likely reflecting findings from recent high-impact studies. Research on tranexamic acid has increased (5 versus 7) as have studies on other pharmacological agents (4 versus 8).

conclusionsThe number of ongoing RCTs in CSDH has increased substantially, with a notable shift in research focus. MMAE now dominates the field, though the surge in studies may suggest research saturation. Future investigations may benefit from more collaborative efforts, consolidating resources into fewer, but larger and adequately powered trials.

Indexed as

Embolization, TherapeuticHematoma, Subdural, ChronicRandomized Controlled Trials as TopicHumansBHCCorticosteroidsCSDHMMAERCTsRoB 2

Identifiers

PMID41196366
PMCPMC12592311

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.