Patient Information

See attached patient information leaflet below for full information about the condition; Chronic Subdural haematoma, including pictures.

The Dex-CSDH study aims to look at whether a two-week course of dexamethasone can improve survival and functional outcome in patients with chronic subdural haematomas (CSDH). 

CSDH is a common neurosurgical pathology, affecting 5000 people aged over 65 in the UK each year. It is often related to a relatively minor head injury and result in a collection of blood overlying the surface of the brain. This collection can progress, leading to increased pressure in the head and subsequent neurological deficits, drowsiness and ultimately coma. Many patients require an operation to drain the collection. In addition, the CSDH can recollect and require subsequent further drainage in up to 20% of patients. 

Although not fully understood, the underlying cause of CSDH is suspected to involve an inflammatory process. Therefore recent studies have assessed the role of steroids as an anti-inflammatory in this condition. They have been shown to reduce the recurrence rate of CSDH and we expect that this could lead to reduced mortality and morbidity from CSDH and avoid surgery in some patients. 

We plan to recruit 750-1000 patients with a diagnosis of CSDH from neurosurgical units within the United Kingdom. Patients will be randomised to receive either dexamethasone or a placebo for 14 days from admission to the neurosurgical centre. Patients will then be followed-up for 6 months with questionnaires monitoring recovery and return to normal function. 

At the end of the trial we hope to determine whether dexamethasone can be used as a treatment to help stop recurrence of CSDH and therefore aid recovery. This will influence management of patients with this condition in the future.

Ellie Edlmann,
Sep 17, 2018, 4:18 AM