References

Pia, H. W.; Langmaid, Charles; Zierski, J.

doi:10.1007/978-3-642-95373-6_10

Cited by 2 publications

(3 citation statements)

References 230 publications

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“…Although clear-cut indications are not yet available for all patients, clinical and CT guidelines for therapy are emerging. 10,21,35,36 Several reports have dealt with the timing of operation in patients with hypertensive hemorrhage. Benefit of delayed operation has been assessed by some 34,39_41 and of early operation by others.…”

Section: Surgical Treatmentmentioning

confidence: 99%

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Spontaneous brain hemorrhage.

Ojemann¹,

Heros²

1983

Stroke

117

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Spontaneous brain hemorrhage accounts for about 10% of all strokes and is fatal in about 50% of the cases. Its incidence, in contrast to other types of strokes, has not declined. Hypertension accounts for about half of these hemorrhages; the rest are due to tumors, aneurysms and vascular malformations, inflammatory and degenerative vasculopathies and hematologic and iatrogenic disorders of coagulation. In some patients no cause is ever found. Hypertensive brain hemorrhage occurs in the deep gray nuclei of the hemispheres, the cerebellum, and the pons and results in specific clinical syndromes depending on the location. Computerized tomography has revolutionized the diagnosis of brain hemorrhage and is resulting in the development of rational criteria for medical and surgical management of these lesions. Intensive medical therapy guided by clinical status and continuous monitoring of ICP may improve outcome. Surgical removal of the hematoma is indicated in lobar and putaminal hemorrhages when the patient is deteriorating in spite of vigorous medical therapy. In addition most large (greater than 3 cm) cerebellar hemorrhages, as well as smaller cerebellar hemorrhages that result in significant brain stem compression should be evaluated. The roles of intensive medical therapy, elective late surgery and of immediate operation in improving eventual functional outcome need to be investigated further.

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Section: Surgical Treatmentmentioning

confidence: 99%

“…234, 35 Patients with small hematomas will generally respond to medical therapy as will most patients with moderate size hematomas. 10 -20,36,37 These patients are awake and can be followed by clinical examination and monitoring of ICP is usually not necessary.…”

Section: Medical Treatmentmentioning

confidence: 99%

Spontaneous brain hemorrhage.

Ojemann¹,

Heros²

1983

Stroke

117

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“…Thanks to the advances of surgical technique selective treatment of putaminal hematomas [58], intraventricular hematomas with partial ventricular tamponade [56] and brain stem hematomas [57] has become possible. Though arterial hypertension is the most common cause of these hemorrhages, aneurysms and microangiomas are detected in older age groups much more frequently than before [57,58]. There are no particular surgical problems which are of importance once it has been decided that the hematoma has to be evacuated.…”

Section: Spontaneous Intracerebral and Intraventricular Hemorrhagementioning

confidence: 99%

The future role of neurosurgery in the case of vascular diseases of the central nervous system

Pia

1986

Neurosurg. Rev.

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On the basis of 2542 cerebro-spinal vascular diseases (933 aneurysms, 689 cerebro-spinal angiomas, 410 spontaneous intracerebral hematomas, 361 vascular bypass operations and 149 endarterectomies of neck vessels) the present situation and problems, as well as the future prospects of cerebral vascular neurosurgery are reviewed. It is expected that the main development will take place in the field of pathophysiology and pathochemistry of vascular diseases through the acquisition of data obtained not in experimental studies but in patients. This will refine the diagnosis and indications. It is not expected that the operative technique will undergo very substantial change. New methods in the application of laser and photosensitization techniques will be probably included in the technical armamentarium. Endovascular methods of treatment will be further developed and will lead to the limitation of the indications for direct operation. It is assumed that mortality and morbidity can be further reduced by improving the diagnosis and establishing the optimal lines of therapy.

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References

Cited by 2 publications

References 230 publications

Spontaneous brain hemorrhage.

Spontaneous brain hemorrhage.

The future role of neurosurgery in the case of vascular diseases of the central nervous system

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