Department of Neurology, University of Heidelberg, Heidelberg, Germany.
Int J Stroke. 2010 Jun;5(3):170-7. doi: 10.1111/j.1747-4949.2010.00426.x.
Controversy still exists on surgical management of acute stroke. Even if surgical therapy represents often a life-saving measure, the issue of acceptable outcome remains open. Persuasive evidence for outcome benefit is limited. For large ischaemic strokes, recent convincing data suggest that decompressive surgery significantly reduces mortality and improves outcome quality. On the other hand, despite the long tradition in surgical removal of intracranial haematomas, the recent evidence has not been sufficient to resolve the basic argument whether to operate or not. Most recently, hopeful preliminary data have emerged on new approaches in the treatment of intraventricular haemorrhage. In this article, we review the current neurosurgical options in acute ischaemic and haemorrhagic stroke.
关于急性脑卒中的手术治疗仍存在争议。即使手术治疗通常是一种挽救生命的措施，但可接受的结果仍存在争议。支持手术治疗获益的证据有限。对于大面积缺血性脑卒中，最近令人信服的数据表明，减压手术可显著降低死亡率并改善预后质量。另一方面，尽管在手术清除颅内血肿方面有着悠久的传统，但最近的证据还不足以解决是否进行手术的基本争论。最近，关于治疗脑室内出血的新方法出现了有希望的初步数据。本文回顾了急性缺血性和出血性脑卒中的神经外科治疗选择。
