Treatment of intracerebral hemorrhage: where do we stand?
نویسندگان
چکیده
The recent well-written overview of the advances in stroke over the last decade by Dr. Silver1 has highlighted the controversy over a few options for the treatment of intracerebral hemorrhage (ICH); a result of its complex nature and the variability of its clinical manifestation. Unfortunately, the ICH ADAPT protocol has recently suggested that lower cerebral perfusion and blood pressure do not affect the ICH-induced oedema growth,2 while Starke et al.3 underline that thrombolysisassisted clot evacuation might be more beneficial for certain ICH types (such as deep clots, specific superficial ICH types and those involving intraventricular hemorrhage). On the other side, a 9-point prediction score for hematoma expansion was just published4 aiming toward an individualized treatment and improved trial design in the case of ICH patients; a development of paramount importance in light of the ongoing debate over the criteria leading to a beneficial choice of the nature of ICH treatment studied (amongst others) by the STICH II trial.5 In view of the above, basic and clinical research should be more attentive to the ICH parametropoiesis, neuroimaging and neuromonitoring, while it should by no means abandon the quest for novel, combinatorial and effective conservative approaches.
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ورودعنوان ژورنال:
- Rhode Island medical journal
دوره 97 7 شماره
صفحات -
تاریخ انتشار 2014