Thiex Ruth, Tsirka Stella E
Department of Neurosurgery, Aachen University, Aachen, Germany.
Neurosurg Focus. 2007 May 15;22(5):E6. doi: 10.3171/foc.2007.22.5.7.
Primary intracerebral hemorrhage (ICH) is associated with a high mortality rate and severe morbidity. The treatment of choice is still controversial, given that data from several clinical trials have not provided convincing evidence to support the efficacy of surgical clot removal. Favoring early clot removal is evidence that the limited release of specific neurotoxins associated with the breakdown products of hemoglobin underlies secondary brain injury. Attention has therefore shifted to perilesional brain injury, especially brain edema, as a potential target for therapeutic intervention in patients with ICH. In this review the authors address current understanding of the causes of edema formation following ICH and the treatment options, which are mostly supportive in nature.
原发性脑出血（ICH）与高死亡率和严重的发病率相关。鉴于多项临床试验的数据未能提供令人信服的证据来支持手术清除血凝块的疗效，治疗方法的选择仍存在争议。支持早期清除血凝块的证据是，与血红蛋白分解产物相关的特定神经毒素的有限释放是继发性脑损伤的基础。因此，人们的注意力已转向病灶周围脑损伤，尤其是脑水肿，将其作为ICH患者治疗干预的潜在靶点。在这篇综述中，作者阐述了目前对ICH后水肿形成原因的理解以及治疗选择，这些治疗大多具有支持性。
