医学
病因学
脑出血
重症监护医学
脑积水
凝血病
血肿
冲程(发动机)
质量效应
神经重症监护
外科
蛛网膜下腔出血
内科学
机械工程
工程类
作者
Michael V. Mazya,Jiri Bartek,Björn M. Hansen
出处
期刊:PubMed
日期:2023-09-05
卷期号:120
摘要
Intracerebral hemorrhage (ICH) carries the highest mortality and morbidity of all stroke types. Although small vessel disease accounts for the majority of ICH, there is a broad spectrum of other etiologies. Modern imaging techniques are a cornerstone of the work-up process. The goals of acute management are to prevent hematoma expansion, stabilize and prevent failure of vital functions, and establish the cause of ICH. ICH expansion can be alleviated by rapid correction of any contributing coagulopathy and antihypertensive treatment. Early prognostication within 24 hours after onset is imprecise. For this reason, international guidelines recommend postponing decision-making on withdrawal or limitation of care until at least the second full day of hospitalization. Indications for intensive care differ from those for neurosurgical treatment and should be assessed separately. Neurosurgical treatment is commonly recommended to reduce mortality in the presence of hydrocephalus or infratentorial hematomas with significant mass effect. In deteriorating patients with supratentorial ICH, surgical treatment can be considered as a life-saving treatment on an individual basis, with consideration given to anatomical location, level of consciousness and medical history.
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