Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
Division of Brain Injury Outcomes, Johns Hopkins University, Baltimore, MD, USA.
Neurol Clin. 2021 May;39(2):405-418. doi: 10.1016/j.ncl.2021.02.002. Epub 2021 Mar 31.
Intracerebral hemorrhage is a stroke subtype with high mortality and poor functional outcome in survivors. Its main causes are hypertension, cerebral amyloid angiopathy, and anticoagulant treatment. Hematomas have a high frequency of expansion in the first hours after symptom onset, a process associated with neurologic deterioration and poor outcome. Control of severe hypertension, reversal of anticoagulant effect, and management of increased intracranial pressure are the mainstays of management of intracerebral hemorrhage in the acute phase. Surgical evacuation of the hematoma by conventional craniotomy does not improve outcomes, but minimally invasive techniques may be a valuable approach that deserves further evaluation.
脑出血是一种具有高死亡率和幸存者功能预后不良的脑卒中亚型。其主要病因包括高血压、脑淀粉样血管病和抗凝治疗。血肿在症状出现后的最初数小时内频繁扩大，这一过程与神经功能恶化和不良预后相关。控制严重高血压、逆转抗凝作用以及管理颅内压增高是急性期脑出血管理的主要措施。传统开颅手术清除血肿并不能改善预后，而微创技术可能是一种有价值的方法，值得进一步评估。
