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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Intracerebral hemorrhage
Maria I Aguilar1, Bart M Demaerschalk
1Department of Neurology, Division of Cerebrovascular Diseases, Mayo Clinic Arizona, Phoenix, Arizona 85054, USA.
Insights
This review discusses managing spontaneous intracerebral hemorrhage, highlighting the need for updated guidelines beyond 1999. It addresses common scenarios for non-surgical medical decision-making in acute and long-term patient care.
Area of Science:
- Neurology
- Neurosurgery
- Critical Care Medicine
Background:
- Intracerebral hemorrhage (ICH) management is evolving, with increased non-surgical physician involvement.
- Current therapeutic guidelines for ICH date back to 1999, despite advancements like the STICH and recombinant FVIIa trials.
- There is a gap in evidence-based consensus for managing spontaneous ICH.
Observation:
- Nonsurgeons are increasingly participating in medical decision-making for ICH.
- Recent clinical trials have not yet led to updated comprehensive guidelines.
- Managing ICH requires addressing both acute and long-term patient care scenarios.
Findings:
- The review synthesizes current practices for frequently encountered ICH case scenarios.
- It aims to bridge the gap left by outdated 1999 guidelines.
- Focuses on medical management strategies for spontaneous or non-traumatic ICH.
Implications:
- Updated consensus and guidelines are crucial for optimal ICH patient outcomes.
- Enhanced understanding of ICH management will improve non-surgical physician confidence.
- This review provides a practical resource for clinicians managing ICH patients.
Abstract:
Intracerebral hemorrhage has recently transitioned from being a neurosurgical entity into a condition where nonsurgeons have more participation in the medical decision making. Despite recent advances in the management of intracerebral hemorrhage (i.e., STICH trial and recombinant factor VII trial), guidelines published in 1999 remain the only available therapeutic consensus. The goal of this review is to address frequently encountered case scenarios when managing patients with spontaneous or nontraumatic intracerebral hemorrhage, both acutely and long-term.
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