Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Curr Neurol Neurosci Rep. 2020 Nov 2;20(12):63. doi: 10.1007/s11910-020-01080-0.
The surgical management of trauma-related intracranial hemorrhage is characterized by marked heterogeneity. Large prospective randomized trials have generally been prohibited by the ubiquity of concordant pathology, diversity of trauma systems, and paucity of clinical equipoise among providers.
To date, the results of retrospective studies and surgeon preference have driven the indications, modality, extent, and timing of surgical intervention in the global neurosurgical community. With advances in our understanding of the pathophysiology of hemorrhagic TBI and the advent of novel surgical techniques, a reevaluation of surgical indication, timing, and approach is warranted. In this way, we can work to optimize surgical outcomes, achieving maximal functional recovery while minimizing surgical morbidity.
创伤相关颅内出血的手术治疗具有明显的异质性。由于一致的病理、创伤系统的多样性以及提供者之间临床平衡的缺乏，大型前瞻性随机试验通常受到限制。
迄今为止，回顾性研究和外科医生的偏好结果推动了全球神经外科学术界手术干预的适应证、方式、程度和时机。随着我们对出血性脑损伤病理生理学的理解的进步和新的手术技术的出现，有必要重新评估手术适应证、时机和方法。通过这种方式，我们可以努力优化手术结果，实现最大的功能恢复，同时最大限度地降低手术发病率。
