Evidence map›Paper›PMID 41803988›Full record

Trial reportCritical care (London, England)2026

Awake burr hole craniotomy for chronic subdural hematoma: a phase 2 randomized controlled trial.

Robert Mertens, Clara F Weber, Lukas Depperich, Philipp Spindler, Claudius Jelgersma, Kiarash Ferdowssian, Anton Früh, Peter Truckenmüller, Ahmad Almahozi, Erin D Sprünken and 9 more

Abstract readRandomized Controlled TrialClinical Trial, Phase II
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Robert MertensDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Clara F WeberDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Lukas DepperichDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Philipp SpindlerDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Claudius JelgersmaDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Kiarash FerdowssianDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Anton FrühDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Peter TruckenmüllerDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Ahmad AlmahoziDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Erin D SprünkenInstitute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Theresa KellerInstitute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Anika MüllerDepartment of Anesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Alawi LützDepartment of Anesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Claudia SpiesDepartment of Anesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Friederike TöpperDepartment of Anesthesiology and Intensive Care Medicine (CBF), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Sascha TreskatschDepartment of Anesthesiology and Intensive Care Medicine (CBF), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Nils HechtDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Peter VajkoczyDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany. peter.vajkoczy@charite.de.
Lars WesselsDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionChronic subdural hematoma (cSDH) is a common condition in older adults that often requires neurosurgical evacuation. Postoperative delirium is a frequent and clinically relevant postoperative complication in this population. This study investigated whether burr hole craniotomy for cSDH performed under local anesthesia (LA) reduces the risk of postoperative delirium and complications compared to general anesthesia (GA).

methodsThe ABC-SDH trial was a single-center, open-label, phase 2, prospective randomized clinical trial conducted at a tertiary academic medical center between October 2023 and November 2024. Fifty consecutive patients with a confirmed diagnosis of cSDH underwent burr hole craniotomy performed under either LA or GA. Primary outcomes were postoperative delirium (Confusion Assessment Method, CAM) and complications rates until discharge, and the recruitment rate. Secondary outcomes included procedural times and clinical outcome measures at discharge and at 30-day follow-up.

resultsLA was associated with a significantly lower rate of postoperative delirium (4% vs. 32%, OR 0.09; 95%CI, 0.01–0.79; p = 0.03; NNT = 4). Complications occurred in 8% (LA) versus 32% (GA) (OR 0.18, 95% CI 0.03–0.96; p = 0.08). LA was also associated with significantly reduced procedural times (139.3 ± 53.0 vs. 196.0 ± 52.1 min; p = 0.002). The severity of complications and functional outcomes were comparable between groups.

conclusionLA was associated with significantly lower rates of postoperative delirium and a shorter periprocedural duration compared to GA in patients undergoing cSDH evacuation. As the first prospective trial to systematically assess the incidence of delirium following burr hole craniotomy for cSDH, the ABC-SDH trial highlights the feasibility and safety of LA in a delirium-prone population.

Indexed as

CraniotomyHematoma, Subdural, ChronicWakefulnessAgedAged, 80 and overAnesthesia, GeneralAnesthesia, LocalDeliriumFemaleHumansMalePostoperative ComplicationsProspective StudiesChronic subdural hematomaGeneral anesthesiaLocal anesthesiaPostoperative delirium

Identifiers

PMID41803988
PMCPMC12997716

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.