Hemorrhagic stroke surgery: Difference between revisions
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==Overview== | ==Overview== | ||
The role of surgery for most patients with spontaneous ICH remains controversial. The theoretical rationale for hematoma evacuation revolves around the concepts of preventing herniation, reducing ICP, and decreasing the pathophysiological impact of the hematoma on surrounding tissue by decreasing mass effect or the cellular toxicity of blood products. | The role of surgery for most patients with spontaneous ICH remains controversial. The theoretical rationale for [[hematoma]] evacuation revolves around the concepts of preventing [[herniation]], reducing [[ICP]], and decreasing the pathophysiological impact of the [[hematoma]] on surrounding tissue by decreasing mass effect or the cellular toxicity of blood products. | ||
Additionally, the current recommendations do not apply to [[intracranial hemorrhage]] caused by [[trauma]] or underlying structural lesions such as [[aneurysms]] and arteriovenous malformations, because these patients were not included in the described ICH surgery trials. | |||
==Surgery== | ==Surgery== | ||
Revision as of 18:38, 16 November 2016
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Hemorrhagic stroke Microchapters |
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Diagnosis |
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Treatment |
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AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage (2015) |
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AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012) |
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AHA/ASA Guideline Recommendation for the Primary Prevention of Stroke (2014) |
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AHA/ASA Guideline Recommendations for Prevention of Stroke in Women (2014) Sex-Specific Risk Factors
Risk Factors Commoner in Women |
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Case Studies |
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Hemorrhagic stroke surgery On the Web |
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American Roentgen Ray Society Images of Hemorrhagic stroke surgery |
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Risk calculators and risk factors for Hemorrhagic stroke surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The role of surgery for most patients with spontaneous ICH remains controversial. The theoretical rationale for hematoma evacuation revolves around the concepts of preventing herniation, reducing ICP, and decreasing the pathophysiological impact of the hematoma on surrounding tissue by decreasing mass effect or the cellular toxicity of blood products. Additionally, the current recommendations do not apply to intracranial hemorrhage caused by trauma or underlying structural lesions such as aneurysms and arteriovenous malformations, because these patients were not included in the described ICH surgery trials.
Surgery
Craniotomy for supratentorial hemorrhage
Early hematoma evacuation has not been shown to be beneficial in the 2 latest randomized trials, but high crossover rates of patients to surgical intervention, and narrow patient-based inclusion criteria on early surgery leave unclarified whether surgery may benefit specific groups of patients with supratentorial ICH.