Minimally invasive surgery for intracerebral hemorrhage
| Autor: | Jeffrey R. Vitt, Chung-Huan Sun, J. Claude Hemphill, Peter D Le Roux |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Burial medicine.medical_treatment Clinical Sciences Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Hematoma medicine Volume reduction Humans Minimally Invasive Surgical Procedures cardiovascular diseases Craniotomy minimally invasive surgery Cerebral Hemorrhage Intracerebral hemorrhage business.industry Mass effect 030208 emergency & critical care medicine Thrombolysis medicine.disease diffusion tensor imaging intracerebral hemorrhage Emergency & Critical Care Medicine Surgery Clinical trial Treatment Outcome 030228 respiratory system Invasive surgery business |
| Zdroj: | Current opinion in critical care, vol 26, iss 2 |
| Popis: | Author(s): Vitt, Jeffrey R; Sun, Chung-Huan; Le Roux, Peter D; Hemphill, J Claude | Abstract: Purpose of reviewSpontaneous intracerebral hemorrhage (ICH) is common, associated with a high degree of mortality and long-term functional impairment, and remains without effective proven treatments. Surgical hematoma evacuation can reduce mass effect and decrease cytotoxic effects from blood product breakdown. However, results from large clinical trials that have examined the role of open craniotomy have not demonstrated a significant outcome benefit over medical management. We review the data on minimally invasive surgery (MIS) that is emerging as a treatment modality for spontaneous ICH.Recent findingsThe use of MIS for supratentorial ICH has increased significantly in recent years and appears to be associated with decreased mortality and improved functional outcome compared with medical management. The role of MIS for posterior fossa ICH is ill-defined. Currently available MIS devices allow for stereotactic aspiration and thrombolysis, endoport-mediated evacuation, and endoscopic aspiration. Clinical series demonstrate that MIS can facilitate significant hematoma volume reduction and may be associated with less morbidity than conventional open surgical approaches.SummaryMIS is an appealing treatment modality for supratentorial ICH and with careful patient selection and technologic advances has the potential to improve neurologic outcomes and reduce mortality. Early and extensive hematoma evacuation are important therapeutic targets and current studies are underway that have the potential to change the management for ICH patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|