{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:12:23Z","timestamp":1787008343152,"version":"build-2736575974"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Chronic subdural haematoma (cSDH) is a common subtype of traumatic brain injury, typically affecting older people living with frailty and multimorbidity. Until now, no published guideline has existed internationally to guide management, perhaps explaining why the care of the older cSDH patient varies between neurosurgical centres.<\/jats:p>\n                  <jats:p>The Improving Care in Elderly Neurosurgery Initiative guideline is the first guideline dedicated to the care of patients with cSDH across the entire patient pathway, from initial presentation through to rehabilitation and discharge after surgery. It includes specific recommendations for those patients not requiring surgery who, in the UK, are mostly managed in satellite hospitals away from the tertiary neurosurgical centre. It therefore has relevance to clinicians across the entire UK and also potentially to a broader international audience.<\/jats:p>\n                  <jats:p>In this guideline commentary we summarise the key points for geriatricians and those allied specialties such as acute medicine who deliver care to a large proportion of patients with cSDH.<\/jats:p>\n                  <jats:p>We discuss issues and limitations relating to guideline development, in particular in the rapidly evolving field of Middle Meningeal Artery Embolisation. We also comment on factors which may influence guideline implementation and future service development. Finally we call for some form of national registry in older people sustaining SDH, which may need to be supported by financial incentives to drive investment in services for this historically neglected patient group.<\/jats:p>","DOI":"10.1093\/ageing\/afae280","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T15:20:44Z","timestamp":1738164044000},"source":"Crossref","is-referenced-by-count":4,"title":["Improving care in elderly neurosurgery initiative guideline on management of chronic subdural haematoma in older people-relevance for the geriatrician"],"prefix":"10.1093","volume":"54","author":[{"given":"Frances","family":"Rickard","sequence":"first","affiliation":[{"name":"North Bristol NHS Trust \u2013 Geriatric Medicine, Southmead Hospital , Southmead Road, Bristol BS10 5NB ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Cox","sequence":"additional","affiliation":[{"name":"North Bristol NHS Trust \u2013 Interventional Neuro-radiology , Bristol ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Willliams","sequence":"additional","affiliation":[{"name":"North Bristol NHS Trust \u2013 Neurosurgery , Bristol ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Mortimer","sequence":"additional","affiliation":[{"name":"North Bristol NHS Trust \u2013 Interventional Neuro-radiology , Bristol ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crispin","family":"Wigfield","sequence":"additional","affiliation":[{"name":"North Bristol NHS Trust \u2013 Neurosurgery , Bristol ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Shipway","sequence":"additional","affiliation":[{"name":"North Bristol NHS Trust \u2013 Geriatric Medicine, Southmead Hospital , Southmead Road, Bristol BS10 5NB ,","place":["UK"]},{"name":"University of Bristol , Bristol BS8 1QU ,","place":["UK"]},{"name":"British Geriatrics Society Perioperative Medicine (POPS) SIG , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"key":"2025013017051446000_ref1","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.3171\/2014.9.JNS141550","article-title":"Actual and projected incidence rates for chronic subdural hematomas in United States veterans administration and civilian populations","volume":"123","author":"Balser","year":"2015","journal-title":"J Neurosurg"},{"key":"2025013017051446000_ref2","doi-asserted-by":"crossref","first-page":"424","DOI":"10.25259\/SNI_490_2021","article-title":"Traumatic acute subdural hematoma and coma: Retrospective cohort of surgically treated patients","volume":"12","author":"Bocca","year":"2021","journal-title":"Surg Neurol Int"},{"key":"2025013017051446000_ref3","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1111\/ane.13518","article-title":"Presenting symptoms and functional outcome of chronic subdural hematoma patients","volume":"145","author":"Blaauw","year":"2022","journal-title":"Acta Neurol Scand"},{"key":"2025013017051446000_ref4","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1056\/NEJMoa2214172","article-title":"Decompressive Craniectomy versus craniotomy for acute subdural hematoma","volume":"388","author":"Hutchinson","year":"2023","journal-title":"N Engl J Med"},{"key":"2025013017051446000_ref5","doi-asserted-by":"crossref","first-page":"e050786","DOI":"10.1136\/bmjopen-2021-050786","article-title":"Acute subdural haematoma in the elderly: To operate or not to operate? A systematic review and meta-analysis of outcomes following surgery","volume":"11","author":"Manivannan","year":"2021","journal-title":"BMJ Open"},{"key":"2025013017051446000_ref6","article-title":"Chronic subdural hematoma in patients over 90 years old in a super-aged society","volume":"6","year":"2014","journal-title":"J Clin Med Res."},{"key":"2025013017051446000_ref7","doi-asserted-by":"crossref","first-page":"7020","DOI":"10.1038\/s41598-022-10992-5","article-title":"Prognosis of patients with operated chronic subdural hematoma","volume":"12","author":"Posti","year":"2022","journal-title":"Sci Rep"},{"key":"2025013017051446000_ref8","doi-asserted-by":"crossref","first-page":"e2463","DOI":"10.1002\/brb3.2463","article-title":"National survey on the current practice and attitudes toward the management of chronic subdural hematoma","volume":"12","author":"Holl","year":"2022","journal-title":"Brain Behav"},{"key":"2025013017051446000_ref9","doi-asserted-by":"crossref","first-page":"e418","DOI":"10.1016\/j.wneu.2019.12.011","article-title":"Regional variation in the Management of Nontraumatic Subdural Hematomas across the United States","volume":"135","author":"Robinson","year":"2020","journal-title":"World Neurosurg"},{"key":"2025013017051446000_ref10","volume-title":"Developing NICE Guidelines: The Manual [Internet]."},{"key":"2025013017051446000_ref11","doi-asserted-by":"crossref","first-page":"390","DOI":"10.12688\/wellcomeopenres.18478.1","article-title":"Protocol for the development of a multidisciplinary clinical practice guideline for the care of patients with chronic subdural haematoma","volume":"8","author":"Stubbs","year":"2023","journal-title":"Wellcome Open Res"},{"key":"2025013017051446000_ref12","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1111\/1744-1633.12639","article-title":"Enoxaparin initiation after chronic subdural haematoma evacuation: A randomized clinical trial on timing and outcomes","volume":"27","author":"Shafiei","year":"2023","journal-title":"Surg Pract"},{"key":"2025013017051446000_ref13","volume-title":"2023\/25 NHS Payment Scheme \u2013 a consultation notice."},{"key":"2025013017051446000_ref14","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1227\/neu.0000000000002365","article-title":"Middle meningeal artery embolization versus conventional Management for Patients with chronic subdural hematoma: A systematic review and meta-analysis","volume":"92","author":"Sattari","year":"2023","journal-title":"Neurosurgery"},{"key":"2025013017051446000_ref15","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1136\/jnis-2024-021602","article-title":"Middle meningeal artery embolization for chronic subdural hematoma: An effective treatment with a bright future","volume":"16","author":"Levitt","year":"2024","journal-title":"J NeuroInterventional Surg"},{"key":"2025013017051446000_ref16","doi-asserted-by":"crossref","first-page":"afad240","DOI":"10.1093\/ageing\/afad240","article-title":"New horizons in subdural haematoma","volume":"52","author":"Rickard","year":"2023","journal-title":"Age Ageing"},{"key":"2025013017051446000_ref17","volume-title":"Getting It Right The First Time"}],"container-title":["Age and Ageing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/54\/1\/afae280\/61702802\/afae280.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/54\/1\/afae280\/61702802\/afae280.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T12:05:27Z","timestamp":1738238727000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ageing\/article\/doi\/10.1093\/ageing\/afae280\/7990843"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1,6]]}},"URL":"https:\/\/doi.org\/10.1093\/ageing\/afae280","relation":{},"ISSN":["0002-0729","1468-2834"],"issn-type":[{"value":"0002-0729","type":"print"},{"value":"1468-2834","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,1]]},"published":{"date-parts":[[2025,1]]},"article-number":"afae280"}}