title: The efficacy of dexamethasone on reduction in the reoperation rate of chronic subdural hematoma--the DRESH study: straightforward study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Chronic subdural hematoma (cSDH) is a common neurosurgical disease. It is often considered to be a rather benign entity. In spite of well established surgical procedures cSDH is complicated by a recurrence rate up to 30%. Since glucocorticoids have been used for treatment of cSDH in 1962 their role is still discussed controversially in lack of evident data. On the basis of the ascertained inflammation cycle in cSDH dexamethasone will be an ideal substance for a short lasting, concomitant treatment protocol.
  
  
  OBJECTIVE
  to test the efficacy of dexamethasone on reduction inthe reoperation rate of cSDH.
  
  
  METHODS
  The study is designed as a double-blind randomized placebo-controlled trial 820 patients who are operated for cSDH and from the age of 25 years are included after obtaining informed consent. They are randomized for administration of dexamethasone (16-16-12-12-8-4 mg/d) or placebo (maltodextrin) during the first 48 hours after surgery. The type I error is 5% and the type II error is 20%. The primary endpoint is the reoperation within 12 weeks postoperative.
  
  
  CONCLUSIONS
  This study tests whether dexamethasone administered over 6 days is a safe and potent agent in relapse prevention for evacuated cSDH.
  
  
  BACKGROUND
  EudraCT 201100354442.
authors.affiliation: Christian Doppler Klinik, PMU Salzburg, Universitätsklinik für Neurochirurgie, Ignaz Harrer Str, 79, 5020 Salzburg, Austria. s.emich@salk.at.
authors.forename: Stephan
authors.initials: S
authors.lastname: Emich
authors.forename: Bernd
authors.initials: B
authors.lastname: Richling
authors.forename: Marc R
authors.initials: MR
authors.lastname: McCoy
authors.forename: Rahman Abdul
authors.initials: RA
authors.lastname: Al-Schameri
authors.forename: Feng
authors.initials: F
authors.lastname: Ling
authors.forename: Liyong
authors.initials: L
authors.lastname: Sun
authors.forename: Yabing
authors.initials: Y
authors.lastname: Wang
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hitzl
mesh_terms: D000328:Adult; D001317:Austria; D002681:China; D002985:Clinical Protocols; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D020200:Hematoma, Subdural, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D012086:Reoperation; D012107:Research Design; D055502:Secondary Prevention; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone