Intracerebral Hemorrhage: A Common and Devastating Disease in Need of Better Treatment

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• 作者：Dave Fiorella¹ ; Scott L. Zuckerman² ; ^{scott.zuckerman@vanderbilt.edu" class="auth_mail" title="E-mail the corresponding author} ; Imad S. Khan³ ; Nishant K. Ganesh² ; J. Mocco⁴
• 关键词：Intracerebral hemorrhage ; Hemicraniectomy ; Clot evacuation ; Thrombolysis
• 刊名：World Neurosurgery
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：84
• 期：4
• 页码：1136-1141
• 全文大小：447 K

文摘

To review the poor natural history of intracerebral hemorrhage (ICH), current treatment options for ICH, discuss ongoing trials evaluating minimally invasive techniques for clot evacuation, and offer future directions of investigation for the management of this devastating disease.

Methods

A selective review of recent trials regarding treatment of ICH was performed.

Results

Completed trials of medical and surgical management are reviewed. The supportive research for clot evacuation to limit secondary injury is surveyed. We also provide a comprehensive discussion of current data evaluating minimally invasive techniques to achieve clot removal, including Minimally Invasive Surgery plus tPA for ICH Evacuation (MISTIE), Clot Lysis: Evaluating Accelerated Resolution (CLEAR), and endoscopic evacuation.

Conclusion

We encourage the neurosurgical community to pursue improved therapies for ICH.

Practice

New minimally invasive treatments for ICH are being developed.

Implications

Treatment of ICH is an important area of research and should continue to be aggressively pursued because of the significant societal burden and poor outcomes associated with ICH.