脳内膜内出血: レビュー
Bradley A Gross1, Brian T Jankowitz1, Robert M Friedlander1
1Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
JAMA
|April 3, 2019
まとめ
内膜内出血 (IPH) は,脳卒中の死亡率と罹患率を大きく引き起こす. 最小侵襲的技術を含む迅速な医学的および外科的介入は,患者の成果と回復を改善するために不可欠です.
科学分野:
- 神経学
- 神経外科
- 脳卒中 医学
背景:
- 自発性内出血 (IPH) は,高い死亡率と発症率を持つ重度の脳卒中のサブタイプです.
- 脳卒中の20%未満を占めるにもかかわらず,IPHは重要な臨床的課題を提示しています.
研究 の 目的:
- 内出血の早期発見と総合的な管理の重要性を概説する.
- IPH患者の治療結果を最適化するために,現在および新興の治療戦略をレビューする.
主な方法:
- 血圧のコントロール,凝固病の逆転,脳卒中の治療
- 後方穴の出血と水頭症の既定の手術について話し合う.
- IPHに対する最小侵襲的外科的手法の進行中の研究を強調する.
主要な成果:
- 効果的な管理には,迅速な診断と多面的なアプローチが必要です.
- 手術による切除は,アクセス可能な血管異常 (AVM,洞穴性異常) の標準です.
- 血管内膜栓塞は,ドゥラル AV フィスチュラおよび特定の動脈瘤の重要な内血管戦略です.
結論:
- 内膜内出血は 神経障害や死亡の主な原因です
- 患者の回復には 医療や神経外科の介入が 極めて重要です
- IPHの二次原因の管理を向上させています.
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