Ziai Wendy C, Carhuapoma J Ricardo
Continuum (Minneap Minn). 2018 Dec;24(6):1603-1622. doi: 10.1212/CON.0000000000000672.
This article describes the advances in the management of spontaneous intracerebral hemorrhage in adults.
Therapeutic intervention in intracerebral hemorrhage has continued to focus on arresting hemorrhage expansion, with large randomized controlled trials addressing the effectiveness of rapidly lowering blood pressure, hemostatic therapy with platelet transfusion, and other clotting complexes and clot volume reduction both of intraventricular and parenchymal hematomas using minimally invasive techniques. Smaller studies targeting perihematomal edema and inflammation may also show promise.
The management of spontaneous intracerebral hemorrhage, long relegated to the management and prevention of complications, is undergoing a recent evolution in large part owing to stereotactically guided clot evacuation techniques that have been shown to be safe and that may potentially improve outcomes.
本文描述了成人自发性脑出血管理方面的进展。
脑出血的治疗干预一直聚焦于阻止出血扩大，大型随机对照试验探讨了快速降低血压的有效性、输注血小板进行止血治疗以及使用其他凝血复合物，还有采用微创技术减少脑室内和脑实质血肿的血块体积。针对血肿周围水肿和炎症的小型研究也可能显示出前景。
自发性脑出血的管理长期以来主要是对并发症进行管理和预防，最近正经历演变，这在很大程度上归功于立体定向引导下的血块清除技术，该技术已被证明是安全的，并且可能改善预后。
