Intracerebral hemorrhage treatment [Neurosurgery Wiki]

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====== Intracerebral hemorrhage treatment ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1F_Q3wCk3Vatv9CZ-ShZnqiFYfLD2bdTit5m4M3wXqHU1sBsfE/?limit=15&utm_campaign=pubmed-2&fc=20241020120637}}
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[[GCS]], [[systolic blood pressure]], [[intraventricular hemorrhage]], bleeding [[volume]], and past [[blood pressure]] control are the main factors affecting the [[critical care]] needs of patients with ICH. 
((Wu C, Pan X, Xu L, Lu Z, Wang Z, Xu L, Xu Y. Development of a risk prediction model for critical care needs in patients with intracerebral hemorrhage: a retrospective cohort. BMC Nurs. 2024 Oct 19;23(1):770. doi: 10.1186/s12912-024-02319-8. PMID: 39427213.)).
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Based on the [[MIMIC-III database]], Yi et al. firstly described the dissimilarities in [[survival]] [[probability]], [[mortality]], and neurological [[recovery]] among mainstream treatments for [[intracerebral hemorrhage]]; secondly, patient [[classification]] was determined by important [[clinical features]]; and [[outcome]] variations among treatment groups were compared. The 28-day, 90-day, and in-hospital mortality in the [[craniotomy]] group were significantly lower than [[minimally invasive surgery]] (MIS) and non-surgical group patients; and, the medium/long-term mortality in the MIS group was significantly lower than the non-surgical group. The craniotomy group positively correlated with short-term GCS recovery compared with the MIS group; no difference existed between the non-surgical and MIS groups. The craniotomy group's 90-day survival probability and short-term GCS recovery were superior to the other two treatments in the subgroups of first GCS 3-12; this tendency also presented in the MIS group over the non-surgical group. For milder patients (first GCS > 12), the three treatment regimens had a minimal effect on patient survival, but the non-surgical group showed an advantage in short-term GCS recovery. [[Craniotomy]] patients have lower mortality and a better short-term neurological recovery in an ICH population, especially in short-to-medium term mortality and short-term neurological recovery over MIS patients. In addition, surgical treatment is recommendable for patients with a GCS ≤ 12.
((Yi Y, Che W, Cao Y, Chen F, Liao J, Wang X, Lyu J. Prognostic [[data analysis]]
of [[surgical treatment]]s for [[intracerebral hemorrhage]]. Neurosurg Rev. 2022 Apr 19.
doi: 10.1007/s10143-022-01785-5. Epub ahead of print. PMID: 35441246.)).
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[[Anticoagulation reversal]], intensive blood pressure lowering, neurosurgery and access to critical care might all be beneficial in [[acute intracerebral hemorrhage]] (ICH)
((Parry-Jones AR, Sammut-Powell C, Paroutoglou K, Birleson E, Rowland J, Lee S, 
Cecchini L, Massyn M, Emsley R, Bray B, Patel H. An intracerebral hemorrhage care
bundle is associated with lower case-fatality. Ann Neurol. 2019 Jul 10. doi:
10.1002/ana.25546. [Epub ahead of print] PubMed PMID: 31291031.
)).

===== Spontaneous intracerebral hemorrhage treatment =====

see [[Spontaneous intracerebral hemorrhage treatment]].

===== Traumatic intracerebral hemorrhage treatment =====

see [[Traumatic intracerebral hemorrhage treatment]].