Herbal medicine for hemorrhage-related hydrocephalus: A systematic review of randomised controlled trials

Abstract Background & objective Hemorrhage related hydrocephalus is a common complication intraventricular hemorrhage, subarachnoid hemorrhage, intracranial hemorrhage and traumatic brain injury. It increases morbidity and disability. The aim of this review is to assess the efficacy of herbal medicine for hemorrhage related hydrocephalus. Methods We searched randomized controlled trials (RCTs) investigating herbal medicine through 13 electronic databases. Extracting and assessing the data were performed independently by two authors. The Cochrane risk of bias tool was used to assess the risk of bias. Results We identified 15 trials investing 12 different herbal formulas. The methodological quality was generally low. In the 11 RCTs of comparisons with conventional treatment alone, herbal medicine plus conventional treatment showed a significant improvement on ventriculomegaly after treatment. Also, the 12 RCTs showed a significant difference on clinical signs and symptoms between two groups. We pooled the data of five trials compared Zhongfengxingnao liquid and Salviae Miltiorrhizae Radix plus conservative treatment with conservative treatment. There were significant effects on normalizing ventricle volume (Huckman index, RR 2.49; 95% CI 1.24–5.00, n = 80) and improving of Chinese scale of clinical neurologic deficit (MD −8.07; 95% CI −9.40 to −6.75, n = 264). Conclusion Herbal medicine has potential benefits on improving ventriculomegaly and clinical signs and symptoms. However, a relatively small participants number and methodological limitations reduced the strength of the evidence. More rigorous trials are warranted.