大脑内膜内出血:一个回顾
Bradley A Gross1, Brian T Jankowitz1, Robert M Friedlander1
1Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
JAMA
|April 3, 2019
概括
内出血 (IPH) 导致严重的中风死亡率和发病率. 迅速的医疗和手术干预,包括最少的侵入性技术,对于改善患者的结果和康复至关重要.
科学领域:
- 神经学
- 神经外科
- 脑卒中医学
背景情况:
- 自发性内出血 (IPH) 是一种严重的中风亚型,死亡率和发病率很高.
- 尽管不到20%的中风是IPH造成的,但IPH存在重大临床挑战.
研究的目的:
- 概述早期识别和综合治疗内出血的关键重要性.
- 审查目前和新兴的治疗策略,以优化IPH患者的治疗结果.
主要方法:
- 专注于基本的医疗干预:血压控制,凝血病逆转和中风病房护理.
- 讨论后出血和脑水的已知的手术治疗方法.
- 突出目前正在进行的对 supratentorial IPH的微创手术技术的研究.
主要成果:
- 有效的管理取决于快速诊断和多方面的方法.
- 手术切除是可访问的血管形 (AVM,洞腔形) 的标准.
- 血管内栓塞是对长脉动脉和某些动脉瘤的关键内血管策略.
结论:
- 内出血仍然是导致神经障碍和死亡的主要原因.
- 及时的医疗和神经外科干预对于患者的康复至关重要.
- 随着微创和内血管技术的发展,二次性IPH病因的治疗得到了改善.
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