Can Low-Dose Radiation Therapy (LD-RT) Aid in Chronic Subdural Hematoma (cSDH) Management? Literature Review and Proposed Clinical Trial Design

Introduction + Methods Chronic subdural hematoma (cSDH) is a common neurosurgical condition, complicated by high rates of hematoma recurrence. There is growing interest in less invasive management options for primary and adjunctive treatment, such as middle meningeal artery embolization (MMAE). Low-dose radiation therapy (LD-RT) is an emerging noninvasive treatment for a range of inflammatory conditions, raising the question of whether LD-RT could benefit cSDH patients. Literature review was conducted to describe cSDH pathophysiology, the therapeutic mechanisms of LD-RT, and any clinical evidence supporting the efficacy of LD-RT for cSDH. Based on these findings, a randomized controlled trial design and LD-RT regimen were proposed to evaluate safety and efficacy.