This transcript has been edited for clarity.
Dear colleagues, I'm Christoph Diener from the University of Duisburg-Essen in Germany, here to tell you about five interesting neurology studies published in December 2020.
The first study of interest is in neuro-traumatology. People with subdural hematomas are usually treated by surgery. However, there is a hypothesis that perhaps dexamethasone could have an impact on the outcome of this condition, given the presence of inflammation within the dura and leakage of small vessels in chronic subdural hematoma.
In a study published in The New England Journal of Medicine, UK investigators randomized 748 patients with symptomatic chronic subdural hematoma to either dexamethasone or placebo. Of the patients, 94% underwent surgery. The primary outcome was a modified Rankin score between 0 and 3, which was achieved in 84% of patients on dexamethasone vs 90% on placebo, meaning placebo was superior to dexamethasone (P = .01). In conclusion, there is no indication to use corticosteroids in patients with chronic subdural hematoma.
The second study investigated the prehospital use of tranexamic acid in patients with severe traumatic brain injurywho were flown by helicopter to a trauma center. Data were analyzed from a registry in the Netherlands, with a primary endpoint of 30-day mortality.
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COMMENTARY
5 Updates in Neurology
Hans-Christoph Diener, MD, PhD
DisclosuresJanuary 20, 2021
This transcript has been edited for clarity.
Dear colleagues, I'm Christoph Diener from the University of Duisburg-Essen in Germany, here to tell you about five interesting neurology studies published in December 2020.
The first study of interest is in neuro-traumatology. People with subdural hematomas are usually treated by surgery. However, there is a hypothesis that perhaps dexamethasone could have an impact on the outcome of this condition, given the presence of inflammation within the dura and leakage of small vessels in chronic subdural hematoma.
In a study published in The New England Journal of Medicine, UK investigators randomized 748 patients with symptomatic chronic subdural hematoma to either dexamethasone or placebo. Of the patients, 94% underwent surgery. The primary outcome was a modified Rankin score between 0 and 3, which was achieved in 84% of patients on dexamethasone vs 90% on placebo, meaning placebo was superior to dexamethasone (P = .01). In conclusion, there is no indication to use corticosteroids in patients with chronic subdural hematoma.
The second study investigated the prehospital use of tranexamic acid in patients with severe traumatic brain injurywho were flown by helicopter to a trauma center. Data were analyzed from a registry in the Netherlands, with a primary endpoint of 30-day mortality.
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Cite this: Hans-Christoph Diener. 5 Updates in Neurology - Medscape - Jan 20, 2021.
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Authors and Disclosures
Authors and Disclosures
Author(s)
Hans-Christoph Diener, MD, PhD
Professor, Department of Neurology, Stroke Center-Headache Center, University Duisburg-Essen, Essen, Germany
Disclosure: Hans-Christoph Diener, MD, PhD, has disclosed the following relevant financial relationships:
Received honoraria for participation in clinical trials, contribution to advisory boards or oral presentations from: Abbott; Addex Pharma; Alder; Allergan; Almirall; Amgen; Autonomic Technology; AstraZeneca; Bayer Vital; Berlin Chemie; Bristol-Myers Squibb; Boehringer Ingelheim; Chordate; CoAxia; Corimmun; Covidien; Coherex; CoLucid; Daiichi-Sankyo; D-Pharml Electrocore; Fresenius; GlaxoSmithKline; Grunenthal; Janssen-Cilag; Labrys Biologics Lilly; La Roche; 3M Medica; MSD; Medtronic; Menarini; MindFrame; Minster; Neuroscore; Neurobiological Technologies; Novartis; Novo-Nordisk; Johnson & Johnson; Knoll; Paion; Parke-Davis; Pierre Fabre; Pfizer Inc; Schaper and Brummer; sanofi-aventis; Schering-Plough; Servier; Solvay; Syngis; St. Jude; Talecris; Thrombogenics; WebMD Global; Weber and Weber; Wyeth; Yamanouchi
Received financial support for research projects from: Allergan; Almirall; Astra/Zeneca; Bayer; Boehringer Ingelheim; Electrocore; GlaxoSmithKline; Janssen-Cilag; Lundbeck; MSD; Novartis; Pfizer; sanofi-aventis; Syngis; Talecris
Within the past year Dr Diener served as editor of Aktuelle Neurologie, Arzneimitteltherapie, Kopfschmerznews, Stroke News, and the Treatment Guidelines of the German Neurological Society; as co-editor of Cephalalgia, and on the editorial board of Lancet Neurology, Stroke, European Neurology, and Cerebrovascular Disorders.
The Department of Neurology in Essen is supported by the German Research Council (DFG), the German Ministry of Education and Research (BMBF), European Union, National Institutes of Health, Bertelsmann Foundation, and Heinz-Nixdorf Foundation.
Dr Diener has no ownership interest and does not own stocks in any pharmaceutical company.