Department of Neurology, Chobanian and Avedisian School of Medicine, Boston University School of Medicine, Boston, Massachusetts.
Department of Neurology, Boston Medical Center, 1 Boston Medical Center PI, Boston, Massachusetts.
Semin Neurol. 2024 Jun;44(3):281-297. doi: 10.1055/s-0044-1787046. Epub 2024 May 17.
This review delves into updates in management of large hemispheric infarction (LHI), a condition affecting up to 10% of patients with supratentorial strokes. While traditional management paradigms have endured, recent strides in research have revolutionized the approach to acute therapies, monitoring, and treatment. Notably, advancements in triage methodologies and the application of both pharmacological and mechanical abortive procedures have reshaped the acute care trajectory for patients with LHI. Moreover, ongoing endeavors have sought to refine strategies for the optimal surveillance and mitigation of complications, notably space-occupying mass effect, which can ensue in the aftermath of LHI. By amalgamating contemporary guidelines with cutting-edge clinical trial findings, this review offers a comprehensive exploration of the current landscape of acute and ongoing patient care for LHI, illuminating the evolving strategies that underpin effective management in this critical clinical domain.
这篇综述深入探讨了大型半球梗死(LHI)的治疗进展,这种情况影响了高达 10%的幕上卒中患者。虽然传统的管理模式仍然存在,但最近在研究方面的进展彻底改变了急性治疗、监测和治疗的方法。值得注意的是,分诊方法的进步以及药物和机械阻断程序的应用,重塑了 LHI 患者的急性护理轨迹。此外,正在进行的努力旨在完善最佳监测和缓解并发症的策略,特别是占位性肿块效应,这可能是 LHI 后的后果。通过将当代指南与最新的临床试验结果相结合,本综述全面探讨了 LHI 患者的急性和持续护理的现状,阐明了支撑这一关键临床领域有效管理的不断发展的策略。