Spontane intrazerebrale Blutungen

Hug, A.; Aschoff, A.; Schwab, Stefan

doi:10.1007/s00115-004-1737-0

Cited by 4 publications

(4 citation statements)

References 91 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Ungefähr 70 der intrakraniellen Blutungen sind intrazerebrale Blutungen, wobei ca. 15 OATassoziiert sind [44], die Mehrzahl der restlichen sind Subduralhämatome [39].…”

Section: Epidemiologieunclassified

See 1 more Smart Citation

Antikoagulanzienassoziierte Hirnblutungen

Jüttler

Hug

et al. 2006

Nervenarzt

Self Cite

View full text Add to dashboard Cite

Intracerebral hemorrhage (ICH) is the most serious complication of oral anticoagulant therapy (OAT). The growing use of OAT has resulted in an increase of fatal ICH. The mortality rate is about 65%, and most of the surviving patients remain disabled. While improvements in the treatment of spontaneous ICH have recently been described, there are no internationally accepted guidelines for managing patients with OAT-ICH. Therefore, identifying effective treatments is essential for improving clinical outcome. This article reviews the epidemiology of OAT-ICH, its pathophysiology, and current treatment options and discusses open questions with particular respect to more recent pharmacological therapies.

show abstract

“…Ungefähr 70 der intrakraniellen Blutungen sind intrazerebrale Blutungen, wobei ca. 15 OATassoziiert sind [44], die Mehrzahl der restlichen sind Subduralhämatome [39].…”

Section: Epidemiologieunclassified

“…Generell sollte bei allen Hirnblutungspatienten unter Antikoagulation eine schnelle und vollständige Korrektur der Gerinnung erfolgen. Ein inkompletter Ausgleich ist wahrscheinlich mit einem erhöhten Nachblutungsrisiko verbunden [10,44]. Während der akuten Phase einer OAT-ICB werden die oralen Antikoagulanzien gewöhnlich abgesetzt.…”

Section: Dosierungenunclassified

Antikoagulanzienassoziierte Hirnblutungen

Jüttler

Hug

et al. 2006

Nervenarzt

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

“…Spontaneous intracerebral hemorrhage (ICH) accounts for 10-15% of acute stroke and is still associated with high mortality and poor clinical outcomes [1][2][3]. Ar-DOI: 10.1159/000510040 terial hypertension, amyloid angiopathy, anticoagulation, and underlying vascular malformations have been identified as risk factors [1]. Clinical signs and symptoms depend on the volume of the hematoma, its localization, its extensions (e.g., into the ventricles), and the development of edema [4,5].…”

Section: Introductionmentioning

confidence: 99%

Dexamethasone in Patients with Spontaneous Intracerebral Hemorrhage: An Updated Meta-Analysis

et al. 2020

View full text Add to dashboard Cite

Background: Spontaneous intracerebral hemorrhage (ICH) is a frequent cerebrovascular disorder and still associated with high mortality and poor clinical outcomes. The purpose of this review was to update a 15-year-old former meta-analysis on randomized clinical trials (RCTs) addressing the question of whether ICH patients treated with dexamethasone have better outcomes than controls. Methods: The electronic databases PubMed, SCOPUS, and Cochrane as well as web platforms on current clinical trials were searched for the years 1970–2020 without constriction on language. Data were extracted and outcomes were pooled for conventional and cumulative meta-analysis using a commercial software program (www.Meta-Analysis.com). Results: Finally, 7 RCTs were identified and analyzed including 248 participants in the dexamethasone groups and 242 in the control groups. Five studies showed a high risk of bias. The overall relative risk (RR) for death was 1.32 (95% confidence interval [CI] 0.99–1.76; p = 0.06) and did not differ significantly between the 2 groups. After exclusion of studies with high risk of bias, the RR for death was 1.37 (95% CI 0.54–3.42; p = 0.51). The RR for poor outcome did not differ significantly between the 2 groups analyzed for all included studies (RR = 0.69; 95% CI 0.47–1; p = 0.05) and after exclusion of studies with high risk of bias (RR = 0.7; 95% CI 0.45–1.08; p = 0.11). The RR for complications did not differ significantly including all studies (RR = 1.29; 95% CI 0.77–2.17; p = 0.34) and after exclusion of studies with high risk of bias (RR = 1.27; 95% CI 0.18–8.89; p = 0.81). The cumulative statistics delivered no other results; however, it pointed out fewer complications over time in the dexamethasone group. Conclusion: Clear evidence of a beneficial or negative effect of dexamethasone is still lacking. Modern RCTs or observational studies with propensity design are necessary to evaluate the efficacy and safety of treatment with dexamethasone in patients with ICH.

show abstract

Die operationspflichtige spontane intrazerebrale Blutung?Bedeutung der CT-Angiographie in der pr�operativen Notfalldiagnostik

Hünerbein

Klötzer

Ladanyi

et al. 2003

Klinische Neuroradiologie

View full text Add to dashboard Cite

ZusammenfassungHintergrund: Welche Informationen kann die CT-Angiographie (CTA) im Rahmen der Notfalldiagnostik bei Patienten mit operationspflichtiger nichttraumatischer Hirnmassenblutung liefern? Patienten und Methode: Bei 61 Patienten mit nichttraumatischer Hirnmassenblutung und dringlicher Operationsindikation wurde im Anschluss an das Nativ-CT eine CTA zur Blutungsquellensuche durchgeführt. Die Befunde der CTA wurden mit dem intraoperativen Befund und der histologischen Aufarbeitung der Operationspräparate verglichen. Die CTAs der Patienten mit operativ nachgewiesener Gefäßmalformation wurden retrospektiv nach spezifischen Befundkriterien analysiert. Ergebnisse: Die CTA konnte präoperativ 13 arteriovenöse Malformationen (AVM), eine Carotis-Sinus-cavernosus-Fistel und drei Aneurysmen als Blutungsquelle richtig nachweisen. In einem Fall bestätigte sich der Angiomverdacht operativ nicht. Singuläre oder komplexe pathologische Gefäßstrukturen in der CTA haben eine sichere Korrelation mit den operativen und histologischen Befunden eines AV-Angioms. Punktförmige Kontrastmittelaustritte im Hämatom sind dagegen unsichere Befundkriterien für ein Angiom. Schlussfolgerung: Bei der raumfordernden Massenblutung bleibt oft keine Zeit für eine diagnostische DSA zur Blutungsquellensuche. Mit einer im Anschluss an das Nativ-CT durchgeführten CTA lassen sich größere Angiome und periphere Aneurysmen als Blutungsursache ohne wesentlichen Zeitverzug nachweisen. Schlüsselwörter: Intrazerebrale Blutung · CT · CTA · DSAAbstract Background: What diagnostic information can emergent CT angiography (CTA) supply in the setting of nontraumatic massive intracerebral hemorrhage requiring surgical treatment? Patients and Methods: In 61 patients with massive nontraumatic intracerebral hemorrhage requiring urgent surgical treatment a CTA following a nonenhanced CT (NECT) was performed. The results of the CTA were compared with the intraoperative and histological findings. In the cases with histologically proven vascular malformations the CTAs were retrospectively analyzed according to specified criteria. Results: CTA was able to correctly identify 13 arteriovenous malformations, one carotid cavernous fistula and three aneurysms as the underlying cause of the intracerebral hemorrhage. In one case a suspected angioma could not be confirmed intraoperatively. There is a high correlation between single or complex pathological vascular structures in the CTA and intraoperative and histological findings of AVMs. In contrast, nodular appearing extravasation of the contrast agent within the hematoma is an unreliable finding with regard to the presence of an angioma.

show abstract

Spontane intrazerebrale Blutungen

Cited by 4 publications

References 91 publications

Antikoagulanzienassoziierte Hirnblutungen

Antikoagulanzienassoziierte Hirnblutungen

Dexamethasone in Patients with Spontaneous Intracerebral Hemorrhage: An Updated Meta-Analysis

Die operationspflichtige spontane intrazerebrale Blutung?Bedeutung der CT-Angiographie in der pr�operativen Notfalldiagnostik

Contact Info

Product

Resources

About