Rincon Fred, Mayer Stephan A
Department of Medicine, Division of Neurology and Critical Care, Cooper University Hospital, University of Medicine and Dentistry of New Jersey, Camden, New Jersey, USA.
Curr Opin Neurol. 2010 Feb;23(1):59-64. doi: 10.1097/WCO.0b013e3283352c01.
Spontaneous intracerebral hemorrhage (ICH) is the most devastating type of stroke and a leading cause of disability and mortality in the United States and the rest of the world. The purpose of this article is to review recent advances in the management of spontaneous intracerebral hemorrhage.
Although no interventions have consistently shown an improvement of mortality or functional outcomes after ICH, results from multicenter prospective randomized controlled trials have shown that early hemostasis to prevent hematoma growth, removal of clot by surgical or minimally invasive interventions, clearance of intraventricular hemorrhage, and adequate blood pressure control for the optimization of cerebral perfusion pressure may constitute the most important therapeutic goals to ameliorate secondary neurological damage, decrease mortality, and improve functional outcomes after ICH.
Several promising methods may be ready for routine clinical use in a few years to decrease disability and mortality from ICH.
自发性脑出血(ICH)是最具破坏性的中风类型,也是美国及世界其他地区残疾和死亡的主要原因。本文旨在综述自发性脑出血治疗的最新进展。
尽管尚无干预措施能持续改善脑出血后的死亡率或功能结局,但多中心前瞻性随机对照试验的结果表明,早期止血以防止血肿扩大、通过手术或微创干预清除血凝块、清除脑室内出血以及适当控制血压以优化脑灌注压,可能是减轻脑出血后继发性神经损伤、降低死亡率和改善功能结局的最重要治疗目标。
几年内可能有几种有前景的方法可用于常规临床,以降低脑出血导致的残疾和死亡率。