The management of chronic subdural hematomas (cSDH) has come back into vogue in recent years with much of the focus on endovascular embolization of the middle meningeal artery to prevent recurrence following surgical evacuation. ^{Reference Fiorella, Monteith and Hanel1,Reference Davies, Knopman and Mokin2} Given the large volume of patients with cSDH and their increasing incidence, even marginal gains can have significant health systems effects. ^{Reference Feghali, Yang and Huang3} With this in mind, Ong and colleagues present a well-conducted scoping review of the literature comparing outcomes of early vs late mobilization following evacuation. ^{Reference Ong, Chang, Cruz, Rebchuk and Makarenko4}

Significant dogma has surrounded timing of mobilization following surgery for cSDH. Proponents of late mobilization propose that it promotes brain expansion, thereby reducing recurrence, while advocates of early mobilization invoke Enhanced Recovery After Surgery principles.Reference Staartjes, Spinello, Schwendinger, Germans, Serra and Regli ⁵ Interestingly, following a thorough review of the literature, Ong and colleagues found overall support for early mobilization with fewer medical complications, shorter hospital stays and even better functional recovery in the identified studies.

While methodologically sound, the findings of this review must be taken with some caution. Just four studies were found to examine early vs late mobilization; only one of which was a randomized controlled trial. The true takeaway from this review might be that there is still much work to be done in optimizing postoperative protocols following cSDH evacuation. Complex interventional procedures may be sexier, but perhaps future studies should aim to examine low-hanging fruit, such as timing of mobilization, as a means of improving outcomes following treatment for this ubiquitous pathology.