{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T15:04:50Z","timestamp":1781276690727,"version":"3.54.1"},"reference-count":62,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The aim of the study was to evaluate the effect of the postoperative Trendelenburg position on the recurrence of chronic subdural hematoma (CSH) in patients after surgical drainage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A pilot randomized, controlled clinical trial was conducted in 3 hospitals in Colombia. Patients with CSH were enrolled and assigned to a Trendelenburg position (30\u00b0 leg elevation and 10\u00b0 head tilt; intervention group) or to a flat position (control group) for 24 hours postoperatively. CSH recurrence was measured at 3 months, along with functional outcome (modified Rankin Scale [mRS] score), adverse events, and patient comfort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Twenty-three patients were assigned to the Trendelenburg group and 23 to the control group. Two patients from the intervention group were assigned to the control group because of minor complications. Recurrence of CSH was 4.8% in the intervention group and 28.6% in the control group (p = 0.038). A favorable outcome (mRS score 0\u20132) was achieved in 95.2% of the intervention group versus 66.7% in the control group (p = 0.025). Patient comfort was equal in both groups (47.6% vs 48%, p = 0.979).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In patients with CSH who require surgery, the postoperative Trendelenburg position is associated with lower recurrence and improved functional outcome at 3 months. Further studies are required to obtain more clinical evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.7.focus25449","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T11:12:32Z","timestamp":1759317152000},"page":"E5","source":"Crossref","is-referenced-by-count":1,"title":["Effect of the postoperative Trendelenburg position on chronic subdural hematoma recurrence: a pilot clinical trial"],"prefix":"10.3171","volume":"59","author":[{"given":"Jorge H.","family":"Montenegro","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Universidad de Antioquia, Medell\u00edn;"},{"name":"Department of Neurosurgery, Cl\u00ednica CES, Medell\u00edn, Colombia;"},{"name":"INUB-MEDITECH Research Group, Universidad El Bosque, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"\u00c1ngel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universidad de Antioquia, Medell\u00edn;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo A.","family":"Botero","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Instituto Neurol\u00f3gico de Colombia, Medell\u00edn;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juanita","family":"Salazar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cl\u00ednica CES, Medell\u00edn, Colombia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia M.","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Universidad de los Andes, M\u00e9rida, Venezuela;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Londo\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universidad de Antioquia, Medell\u00edn;"},{"name":"Department of Neurosurgery, Hospital Pablo Tob\u00f3n Uribe, Medell\u00edn;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d3scar A.","family":"Villada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universidad de Antioquia, Medell\u00edn;"},{"name":"Department of Neurosurgery, Hospital San Vicente Fundaci\u00f3n, Medell\u00edn; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan D.","family":"Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cl\u00ednica CES, Medell\u00edn, Colombia;"},{"name":"Department of Neurosurgery, Hospital San Vicente Fundaci\u00f3n, Medell\u00edn; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeison E.","family":"Montoya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Instituto Neurol\u00f3gico de Colombia, Medell\u00edn;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio A.","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universidad de Antioquia, Medell\u00edn;"},{"name":"Department of Neurosurgery, Cl\u00ednica CES, Medell\u00edn, Colombia;"},{"name":"Department of Neurosurgery, Hospital Pablo Tob\u00f3n Uribe, Medell\u00edn;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s M.","family":"Rubiano","sequence":"additional","affiliation":[{"name":"INUB-MEDITECH Research Group, Universidad El Bosque, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Neurol Med Chir (Tokyo)","first-page":"1","article-title":"Chronic subdural hematoma\u2014evolution of etiology and surgical treatment","volume":"63","author":"Uno M","year":"2023","unstructured":"Uno M. 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