Chronic subdural hematoma (cSDH) is a frequently occurring neurological disease of the elderly and common in daily neurosurgical practice. It consists of an extracerebral encapsulated collection of mostly liquefied old hematoma, located between the dura and arachnoid. The original small, and often asymptomatic, haemorrhage is caused by rupture of a bridging vein after, often minor, head trauma. Due to generalized cerebral atrophy, increased venous fragility, and the more frequent use of anticoagulation therapy, older people are more at risk of developing a cSDH.
Tranexamic acid to prevent operation in chronic subdural haematoma (TORCH)
TORCH is a double-blind, randomized, placebo-controlled multidisciplinary study investigating the efficacy of tranexamic acid in patients with a chronic subdural hematoma (cSDH). The TORCH study is performed in 200 patients with a cSDH who are initially not in need of surgery and are therefore treated conservatively. “We are investigating whether giving tranexamic acid ultimately results in fewer people needing surgery,” Associate Professor Dagmar Verbaan explains.