Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN, USA.
Curr Neurol Neurosci Rep. 2021 Oct 2;21(10):57. doi: 10.1007/s11910-021-01144-9.
Intracerebral hemorrhage (ICH) represents about 15% of all strokes in the USA, but almost 50% of fatal strokes. There are many causes of ICH, but the most common are hypertension and cerebral amyloid angiopathy. This review will discuss new advances in the treatment of intracerebral hemorrhage.
The treatment of ICH focuses on management of edema, aggressive blood pressure reduction, and correction of coagulopathy. Early initiation of supportive medical therapies, including blood pressure management, in a neurological intensive care unit reduces mortality, but at present there is no definitive, curative therapy analogous to mechanical thrombectomy for ischemic stroke. Nonetheless, new medical and surgical approaches promise more successful management of ICH patients, especially new approaches to surgical management. In this review, we focus on the current standard of care of acute ICH and discuss emerging therapies that may alter the landscape of this devastating disease.
在美国,脑出血 (ICH) 约占所有中风的 15%,但几乎占所有中风死亡病例的 50%。ICH 有许多病因,但最常见的是高血压和脑淀粉样血管病。本综述将讨论脑出血治疗方面的新进展。
ICH 的治疗重点在于水肿的管理、积极降压和凝血异常的纠正。在神经重症监护病房中尽早开始支持性的医疗治疗,包括血压管理,可降低死亡率,但目前尚无类似于机械取栓治疗缺血性中风的明确、治愈性疗法。尽管如此,新的医疗和手术方法有望更成功地管理 ICH 患者,特别是在手术管理方面的新方法。在本综述中,我们重点介绍急性 ICH 的当前标准治疗方法,并讨论可能改变这种毁灭性疾病格局的新兴疗法。