title: Chronic subdural haematoma: modern management and emerging therapies.
abstract: Chronic subdural haematoma (CSDH) is one of the most common neurological disorders, and is especially prevalent among elderly individuals. Surgical evacuation is the mainstay of management for symptomatic patients or haematomas exerting significant mass effect. Although burr hole craniostomy is the most widely practised technique worldwide, approximately 10-20% of surgically treated patients experience postoperative recurrence necessitating reoperation. Given the increasing incidence of CSDH in a growing elderly population, a need exists for refined techniques that combine a minimally invasive approach with clinical efficacy and cost-effectiveness. In addition, nonsurgical treatment modalities, such as steroids, are attracting considerable interest, as they have the potential to reduce postoperative recurrence or even replace the need for surgery in selected patients. This Review provides an overview of the contemporary management of CSDH and presents considerations regarding future approaches that could further optimize patient care and outcomes.
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.
authors.forename: Angelos G
authors.initials: AG
authors.lastname: Kolias
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.
authors.forename: Aswin
authors.initials: A
authors.lastname: Chari
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Santarius
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Hutchinson
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use*; D003399:Craniotomy / Q000379:methods*; D019468:Disease Management; D004322:Drainage; D020200:Hematoma, Subdural, Chronic / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012008:Recurrence
chemical_list: D000305:Adrenal Cortex Hormones; D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors