New approaches in the treatment of hypertensive intracerebral hemorrhage

T. Kanno, J. Nagata, K. Nonomura, T. Asai, T. Inoue, T. Nakagawa, F. Mitsuyama

研究成果: Article査読

28 被引用数 (Scopus)

抄録

A comparison of the long-term outcome after surgical and nonsurgical treatment of hypertensive putaminal hemorrhage was performed in Japan over the last 15 years to determine the appropriate role of surgery. The overall results show a poor response to surgical treatment, but neurosurgeons also know that hematoma evacuation may bring about a dramatic result in some cases. In addition, experimental studies have shown that hematoma evacuation improves neuronal function at the penumbra. The discrepancy between the results of this study and the neurosurgeon’s clinical impression is probably a reflection of the following. In the past, the decision to operate was determined mainly by the location of the hemorrhage as determined by computed tomography and/or magnetic resonance imaging. However, this method of deciding surgical indications is probably not correct. We are trying to change the method of determining the surgical indications from morphological to physiological criteria as follows: All patients are initially treated with hyperbaric oxygen, and those who show improvement of their symptoms are clearly indicated for surgery. If the somatosensory evoked potential or auditory brain stem response shows an improvement after administration of mannitol or gelcerol, this is also an indication that surgery should be performed.

本文言語English
ページ(範囲)I-96-I-100
ジャーナルStroke
24
12
出版ステータスPublished - 12-1993

All Science Journal Classification (ASJC) codes

  • 臨床神経学
  • 循環器および心血管医学
  • 高度および特殊看護

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