Fisher M
Department of Neurology, Medical Center of Central Massachusetts, Worcester 01605.
Arq Neuropsiquiatr. 1991 Sep;49(3):233-42. doi: 10.1590/s0004-282x1991000300001.
The diagnosis of primary intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) has become easier with the advent of modern imaging techniques. The incidence of ICH has declined, while SAH has remained relatively constant. The prognosis for both disorders remains dismal and the mortality rate is substantially higher than that observed with ischemic stroke. Early imaging with CT or MRI is important for rapid and accurate diagnosis. General medical management in a skilled nursing facility should be available for patients who are not moribund. Therapy for ICH is predominantly supportive and effective medical and surgical intervention remains elusive. For SAH, calcium channel blockers may reduce cerebral ischemic complications related to vasospasm, but effective medical therapy to prevent rebleeding has not been established. Early surgery after SAH should be considered in clinically stable patients. Many challenges remain regarding the prevention and treatment of both these cerebral hemorrhage subtypes.
随着现代成像技术的出现，原发性脑出血（ICH）和蛛网膜下腔出血（SAH）的诊断变得更加容易。脑出血的发病率有所下降，而蛛网膜下腔出血则相对保持稳定。这两种疾病的预后仍然很差，死亡率明显高于缺血性中风。早期进行CT或MRI成像对于快速准确的诊断很重要。对于非濒死患者，应在专业护理机构进行综合医疗管理。脑出血的治疗主要是支持性的，有效的药物和手术干预仍然难以实现。对于蛛网膜下腔出血，钙通道阻滞剂可能会减少与血管痉挛相关的脑缺血并发症，但尚未确立有效的预防再出血的药物治疗方法。对于临床稳定的蛛网膜下腔出血患者，应考虑早期手术。在这两种脑出血亚型的预防和治疗方面仍存在许多挑战。
