Acute Stroke Programme, Department of Medicine and Clinical Geratology, Oxford University Hospitals NHS Trust, Oxford, UK.
Lancet Neurol. 2012 Jan;11(1):101-18. doi: 10.1016/S1474-4422(11)70264-2.
Intracerebral haemorrhage (ICH) is the most devastating type of stroke and is a leading cause of disability and mortality. By contrast with advances in ischaemic stroke treatment, few evidence-based targeted treatments exist for ICH. Management of ICH is largely supportive, with strategies aimed at the limitation of further brain injury and the prevention of associated complications, which add further detrimental effects to an already lethal disease and jeopardise clinical outcomes. Complications of ICH include haematoma expansion, perihaematomal oedema with increased intracranial pressure, intraventricular extension of haemorrhage with hydrocephalus, seizures, venous thrombotic events, hyperglycaemia, increased blood pressure, fever, and infections. In view of the restricted number of therapeutic options for patients with ICH, improved surveillance is needed for the prevention of these complications, or, when this is not possible, early detection and optimum management, which could be effective in the reduction of adverse effects early in the course of stroke and in the improvement of prognosis. Further studies are needed to enhance the evidence-based recommendations for the management of this important clinical problem.
脑出血(ICH)是最具破坏性的中风类型,也是残疾和死亡的主要原因。与缺血性中风治疗的进展相比,针对 ICH 的循证靶向治疗方法很少。ICH 的治疗主要是支持性的,策略旨在限制进一步的脑损伤和预防相关并发症,这对已经致命的疾病产生了进一步的不利影响,并危及临床结果。ICH 的并发症包括血肿扩大、伴颅内压升高的血肿周围水肿、出血向脑室扩展伴脑积水、癫痫发作、静脉血栓形成事件、高血糖、高血压、发热和感染。鉴于 ICH 患者的治疗选择有限,需要加强监测以预防这些并发症,或者在无法预防的情况下,早期发现和最佳管理,这可能有助于在中风早期减少不良反应,并改善预后。需要进一步的研究来增强针对这一重要临床问题的循证管理建议。