Naval Neeraj S, Nyquist Paul A, Carhuapoma J Ricardo
Department of Neurology, Division of Neurosciences Critical Care, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
Neurol Clin. 2008 May;26(2):373-84, vii. doi: 10.1016/j.ncl.2008.03.002.
Spontaneous intracerebral hemorrhage (ICH) has the highest mortality of all cerebrovascular events. Thirty-day mortality approaches 50%, and only 20% of survivors achieve meaningful functional recovery at 6 months. Many clinicians believe that effective therapies are lacking; however, this is changing because of new data on the pathophysiology and treatment of ICH, particularly research establishing the role of medical therapies to promote hematoma stabilization. This article provides updates to a recent publication discussing basic principles of ICH management, including initial stabilization, the prevention of hematoma growth, treatment of complications, and identification of the underlying etiology. Minimally invasive surgery (MIS) to reduce clot size is also discussed, with the goal of preserving neurologic function through reduction in parenchymal damage from edema formation.
自发性脑出血（ICH）在所有脑血管事件中死亡率最高。30天死亡率接近50%，且只有20%的幸存者在6个月时能实现有意义的功能恢复。许多临床医生认为缺乏有效的治疗方法；然而，由于关于ICH病理生理学和治疗的新数据，尤其是确定促进血肿稳定的医学疗法作用的研究，这种情况正在改变。本文对最近一篇讨论ICH管理基本原则的出版物进行了更新，包括初始稳定、预防血肿扩大、并发症治疗以及确定潜在病因。还讨论了通过减少水肿形成对实质造成的损伤来保留神经功能为目标的减少血凝块大小的微创手术（MIS）。
