Advancements in Managing Intracerebral Hemorrhage: Transition from Nihilism to Optimism

Munakomi, Sunil; Agrawal, Amit

doi:10.1007/5584_2019_351

Cited by 4 publications

(3 citation statements)

References 67 publications

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“…In the United States, the early operation rate was previously 16% and decreased to 6% in 2005, presumably due to the results of the Surgical Treatment for Ischemic Heart Failure (STICH) trial ( 28 , 29 ). With the current increasing interest in surgical treatment, the operation rate has increased to approximately 20% ( 1 , 30 ). In the Asia-Pacific region, the operation rate ranges from 30 to 40% and the MIN method, either stereotactic aspiration or endoscopic-assisted evacuation, is widely used ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Neurosurgery for Spontaneous Intracerebral Hemorrhage—10 Years of Working Progress at National Taiwan University Hospital

et al. 2022

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Intracerebral hemorrhage (ICH) is a life-threatening disease with a global health burden. Traditional craniotomy has neither improved functional outcomes nor reduced mortality. Minimally invasive neurosurgery (MIN) holds promise for reducing mortality and improving functional outcomes. To evaluate the feasibility of MIN for ICH, a retrospective analysis of patients with ICH undergoing endoscopic-assisted evacuation was performed. From 2012 to 2018, a total of 391 patients who underwent ICH evacuation and 76 patients who received early (<8 h) MIN were included. The rebleeding, mortality, and morbidity rates were 3.9, 7.9, and 3.9%, respectively, 1 month after surgery. At 6 months, the median [interquartile range (IQR)] Glasgow Coma Scale score was 12 (4.75) [preoperative: 10 (4)], the median (IQR) Extended Glasgow Outcome Scale score was 3 (1), and the median (IQR) Modified Rankin Scale score was 4 (1). The results suggested that early (<8 h) endoscope-assisted ICH evacuation is safe and effective for selected patients with ICH. The rebleeding, morbidity, and mortality rates of MIN in this study are lower than those of traditional craniotomy reported in previous studies. However, the management of intraoperative bleeding and hard clots is critical for performing endoscopic evacuation. With this retrospective analysis of MIN cases, we hope to promote the specialization of ICH surgery in the field of MIN.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Neurosurgery for Spontaneous Intracerebral Hemorrhage—10 Years of Working Progress at National Taiwan University Hospital

et al. 2022

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“…In fact, a significant percentage of patients die in the short term, while survivors have a considerable residual disability, and are at risk of serious neurological complications such as epilepsy and cognitive impairment. In contrast to ischemic stroke, ICH has also fewer treatment options, and this might induce a † Ludovica De Rosa, Renzo Manara and Claudio Baracchini have contributed equally *Correspondence: Ludovica De Rosa ludovica.derosa@studenti.unipd.it 1 nihilistic approach and a less organized care with negative consequences on prognosis [3]. Furthermore, the growing indications for use of direct oral anticoagulants, coupled with an aging population, suggest that the number of anticoagulated patients will continue to expand, and this might have a negative impact on the epidemiology of ICH [4].…”

Section: Introductionmentioning

confidence: 99%

The “SALPARE study” of spontaneous intracerebral hemorrhage: part 1

Rosa

Manara

Vodret

et al. 2023

Neurol. Res. Pract.

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Background Spontaneous intracerebral hemorrhage (ICH) is a devastating type of stroke with a huge impact on patients and families. Expanded use of oral anticoagulants and ageing population might contribute to an epidemiological change. In view of these trends, we planned a study to obtain a contemporary picture and identify early prognostic factors to improve secondary prevention. Methods This multicenter prospective cohort study included consecutive adult patients with non-traumatic ICH admitted to three academic Italian hospitals (Salerno, Padova, Reggio Emilia) over a 2-year period. Demographic characteristics, vascular risk profile, clinical data and main radiological characteristics were correlated to 90-day clinical outcome. Results Out of 682 patients [mean age: 73 ± 14 years; 316 (46.3%) females] enrolled in this study, 40% died [86/180 (47.8%) in Salerno, 120/320 (37.5%) in Padova, 67/182 (36.8%) in Reggio Emilia; p < 0.05)] and 36% were severely disabled at 90 days. Several factors were associated with a higher risk of poor functional outcome such as antithrombotic drug use, hyperglycemia, previous cerebrovascular accident, low platelet count, and pontine/massive/intraventricular hemorrhage. However, at multivariate analysis only pre-ICH mRS score (OR 30.84), GCS score at presentation (OR 11.88), initial hematoma volume (OR 29.71), and NIHSS score at presentation (OR 25.89) were independent predictors of death and poor functional outcome. Conclusion Despite the heterogeneity among centers, this study on ICH has identified four simple prognostic factors that can independently predict patients outcome, stratify their risk, and guide their management.

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“…The malformed vascular mass and surrounding hyperplasia of glial tissue should be removed as far as possible 3 . With the development of imaging technology and computer planning, multimodal imaging data were processed with corresponding software before surgery and identified the lesion and its adjacent structure; precision therapy can help to improve treatment outcomes and reduce the occurrence of postoperative complications and neurological defects 4–6 . This is a retrospective report of a case of intracranial arteriovenous malformation in functional regions with symptomatic epilepsy performed by the neurosurgery department of our hospital and a review of the relevant literature.…”

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confidence: 99%

Application of 3D SLICER in Cerebral Arteriovenous Malformations in Functional Areas: Case Report

Zhang

Shi

et al. 2023

Journal of Craniofacial Surgery

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The authors report a case of intracranial arteriovenous malformation in functional areas, initially presenting with symptomatic epilepsy was surgically excised by the Neurosurgery Department of our hospital. The patient’s head computed tomography, magnetic resonance imaging, and digital subtraction angiography examination suggested intracranial arteriovenous malformations in the left frontal functional area. A preoperative 3D-reconstruction technique was used to reconstruct the malformed vascular mass, supplying arteries, draining veins, and precise surgical resection was performed. Postoperative pathology indicated vascular malformation. No seizures occurred after surgery. There was no further neurological impairment. Preoperative use of image postprocessing techniques can facilitate precise surgical resection of brain arteriovenous malformations. Three-dimensional Slicer in cerebral arteriovenous malformations in functional areas not only shortened the preoperative planning time but also improved the efficiency of the surgery. Reduce the incidence of postoperative complications. It is helpful for further popularization and application.

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Advancements in Managing Intracerebral Hemorrhage: Transition from Nihilism to Optimism

Cited by 4 publications

References 67 publications

Minimally Invasive Neurosurgery for Spontaneous Intracerebral Hemorrhage—10 Years of Working Progress at National Taiwan University Hospital

Minimally Invasive Neurosurgery for Spontaneous Intracerebral Hemorrhage—10 Years of Working Progress at National Taiwan University Hospital

The “SALPARE study” of spontaneous intracerebral hemorrhage: part 1

Application of 3D SLICER in Cerebral Arteriovenous Malformations in Functional Areas: Case Report

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