Surgical treatment of hypertensive intracerebral hemorrhage
Hypertensive intracerebral hemorrhage (ICH) is a disease with high morbidity, disability rate and mortality. Compared with conservative treatment, the effectiveness of surgery is still controversial. However, surgery is the most promising treatment to improve prognosis of hypertensive ICH. There are...
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Tianjin Huanhu Hospital
2018-12-01
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doaj-50032d80c7e1422188699b2cfc6a935e2020-11-24T21:47:18ZengTianjin Huanhu HospitalChinese Journal of Contemporary Neurology and Neurosurgery1672-67312018-12-01181284584910.3969/j.issn.1672-6731.2018.12.0011830Surgical treatment of hypertensive intracerebral hemorrhageXiao-lei CHEN0Xing-hua XU1Jia-shu ZHANG2Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, ChinaDepartment of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, ChinaHypertensive intracerebral hemorrhage (ICH) is a disease with high morbidity, disability rate and mortality. Compared with conservative treatment, the effectiveness of surgery is still controversial. However, surgery is the most promising treatment to improve prognosis of hypertensive ICH. There are currently three main surgical methods. Craniotomy removes the hematoma under microscope and can achieve reliable hemostasis. Limited by large trauma, relatively long operation time and massive bleeding in operation, the neurological function recovery of patients treated by this procedure is not ideal. Hematoma puncture and catheter drainage brings least injury to normal brain tissue. Nevertheless, the neurosurgeon is unaware of the intracranial situation when operating, and urokinase injection may increase the risk of intracranial infection. Endoscopic hematoma evacuation can completely remove the hematoma, which is less invasive and may avoid damage to nerve fiber bundle. Prospective studies investigating the efficacies of these three surgical approaches are lacking, while the Minimally-Invasive Surgery versus Craniotomy in Patients with Supratentorial Hypertensive Intracerebral Hemorrhage (MISICH) study is expected to provide better data and evidence. DOI: 10.3969/j.issn.1672-6731.2018.12.001http://www.cjcnn.org/index.php/cjcnn/article/view/1875Intracranial hemorrhage, hypertensiveNeurosurgical proceduresReview |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Xiao-lei CHEN Xing-hua XU Jia-shu ZHANG |
spellingShingle |
Xiao-lei CHEN Xing-hua XU Jia-shu ZHANG Surgical treatment of hypertensive intracerebral hemorrhage Chinese Journal of Contemporary Neurology and Neurosurgery Intracranial hemorrhage, hypertensive Neurosurgical procedures Review |
author_facet |
Xiao-lei CHEN Xing-hua XU Jia-shu ZHANG |
author_sort |
Xiao-lei CHEN |
title |
Surgical treatment of hypertensive intracerebral hemorrhage |
title_short |
Surgical treatment of hypertensive intracerebral hemorrhage |
title_full |
Surgical treatment of hypertensive intracerebral hemorrhage |
title_fullStr |
Surgical treatment of hypertensive intracerebral hemorrhage |
title_full_unstemmed |
Surgical treatment of hypertensive intracerebral hemorrhage |
title_sort |
surgical treatment of hypertensive intracerebral hemorrhage |
publisher |
Tianjin Huanhu Hospital |
series |
Chinese Journal of Contemporary Neurology and Neurosurgery |
issn |
1672-6731 |
publishDate |
2018-12-01 |
description |
Hypertensive intracerebral hemorrhage (ICH) is a disease with high morbidity, disability rate and mortality. Compared with conservative treatment, the effectiveness of surgery is still controversial. However, surgery is the most promising treatment to improve prognosis of hypertensive ICH. There are currently three main surgical methods. Craniotomy removes the hematoma under microscope and can achieve reliable hemostasis. Limited by large trauma, relatively long operation time and massive bleeding in operation, the neurological function recovery of patients treated by this procedure is not ideal. Hematoma puncture and catheter drainage brings least injury to normal brain tissue. Nevertheless, the neurosurgeon is unaware of the intracranial situation when operating, and urokinase injection may increase the risk of intracranial infection. Endoscopic hematoma evacuation can completely remove the hematoma, which is less invasive and may avoid damage to nerve fiber bundle. Prospective studies investigating the efficacies of these three surgical approaches are lacking, while the Minimally-Invasive Surgery versus Craniotomy in Patients with Supratentorial Hypertensive Intracerebral Hemorrhage (MISICH) study is expected to provide better data and evidence.
DOI: 10.3969/j.issn.1672-6731.2018.12.001 |
topic |
Intracranial hemorrhage, hypertensive Neurosurgical procedures Review |
url |
http://www.cjcnn.org/index.php/cjcnn/article/view/1875 |
work_keys_str_mv |
AT xiaoleichen surgicaltreatmentofhypertensiveintracerebralhemorrhage AT xinghuaxu surgicaltreatmentofhypertensiveintracerebralhemorrhage AT jiashuzhang surgicaltreatmentofhypertensiveintracerebralhemorrhage |
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