BACKGROUND Chronic subdural haematoma (CSDH) is a pathology that is frequently encountered by neurosurgeons. Nevertheless, there is a lack of guidelines based on solid evidence. There has been a recent and considerable increase in the interest on management and outcomes for CSDH. Therefore, we systematically reviewed all currently running randomised controlled trials (RCTs) in chronic subdural haematoma to understand the areas under investigation and plan future collaborative trials. METHODS Clinical trials databases (Cochrane Controlled Register of Trials, WHO ICTRP and clinical trials.gov) were searched for trials relevant to chronic subdural haematoma. It was then established which trials were currently running and fulfilled robust research methodology for a RCT. RESULTS There are 26 currently running RCTs in CSDH, with the most common topics covering application of steroids (7), surgical techniques (5) and tranexamic acid (5). Further to this, there are trials running on other pharmacological agents (4), middle meningeal artery (MMA) embolisation (2) and peri-operative management (3). CONCLUSIONS Pharmacological agents are a particular focus of CSDH management currently, and a wealth of studies on steroids will hopefully lead to more harmonised, evidence-based practice regarding this in the near future. Surgical techniques and new procedures such as MMA embolisation are also important focuses for improving patient outcomes. There is an on-going need for future RCTs and evidence-based guidelines in CSDH, particularly including low- and middle-income countries, and it is hoped that the establishment of the iCORIC (International COllaborative Research Initiative on Chronic Subdural Haematoma) will help address this.

中文翻译：

---

对当前慢性硬膜下血肿随机对照试验的系统评价和国际合作方法的建议。

背景慢性硬膜下血肿(CSDH)是神经外科医生经常遇到的病理。然而，缺乏基于确凿证据的指导方针。最近对 CSDH 的管理和结果的兴趣显着增加。因此，我们系统地审查了所有目前正在进行的慢性硬膜下血肿随机对照试验 (RCT)，以了解正在研究的领域并计划未来的合作试验。方法 临床试验数据库（Cochrane Controlled Register of Trials、WHO ICTRP 和clinicaltrials.gov）被搜索与慢性硬膜下血肿相关的试验。然后确定当前正在运行哪些试验并实现了 RCT 的稳健研究方法。结果 CSDH 目前有 26 个正在运行的 RCT，最常见的主题包括类固醇的应用 (7)、手术技术 (5) 和氨甲环酸 (5)。除此之外，还有其他药物 (4)、脑膜中动脉 (MMA) 栓塞 (2) 和围手术期管理 (3) 的试验。结论 目前，药物制剂是 CSDH 管理的一个特别关注点，大量关于类固醇的研究有望在不久的将来导致更协调的、基于证据的实践。手术技术和 MMA 栓塞等新程序也是改善患者预后的重要重点。CSDH 需要未来的 RCT 和循证指南，特别是包括低收入和中等收入国家，