RATIONALE

Chronic subdural hematoma (CSDH) is a common neurological disease, occurring mainly in the elderly.


Surgical evacuation is an effective treatment, but is also associated with life-threatening risks. In these old, often frail, patients with multi-comorbidity, surgery also comes with significant risks for future cognitive functioning and, therefore, loss of independency.


In five small retrospective series, tranexamic acid (TXA), an antifibrinolytic drug, showed a beneficial effect on the spontaneous resolution of the hematoma and, with that, the necessity for surgery.


The TORCH is a randomized, placebo-controlled clinical trial which aims to prove the efficacy of TXA.