Spontaneous hypertensive brainstem hemorrhage: Does surgery benefit the severe cases?

Lan, Zhigang; Richard, Seidu A.; Li, Hao; Chen, Maojun; You, Chao

doi:10.1016/j.inat.2018.10.015

Cited by 13 publications

(26 citation statements)

References 17 publications

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“…Ten studies were selected for systemic analysis, including 2 RCTs[ 12 , 17 ] and 8 NRCCTs [ 5 , 19 , 22 , 24 , 26 , 33 , 39 , 50 ] (Table 1 ). The sample size ranged from 21 to 326, including 304 surgically treated patients and 640 conservatively treat with/without EVD patients, comprising 944 participants.…”

Section: Resultsmentioning

confidence: 99%

“…It showed that 36% of HBSH patients would develop hydrocephalus initially. [ 24 ] Acute hydrocephalus is caused by the direct oppression of the hematoma or blockage of intraventricular hemorrhage. It is manageable and reversible but makes patients look worse than they really are.…”

Section: Discussionmentioning

confidence: 99%

“…When referred to the mortality rate, families’ decision on the treatment plan is critical. Only two studies clearly stated that “patients whose families decided giving up treatment were excluded”[ 17 , 50 ], and one study[ 24 ] stated that “patients whose families refused to have surgery were served as the control group.” This resulted in significant selection bias for further analysis because (1) family refused to have surgery may imply that they were unable or unwilling to financially support the advanced treatment; (2) these patients may receive a relatively negative treatment, or “futile treatment”[ 11 ], from the aspect of medical staff. These will increase the mortality rate in the CM group.…”

Section: Discussionmentioning

confidence: 99%

“…Various outcome scores were applied in different studies. A good outcome was defined if (1) GOS > 3[ 12 , 17 , 19 ], (2) mRS < 3[ 24 , 39 ], (3) National Institute of Health stroke scale (NIHSS) decrease 45% after treatment[ 5 , 22 , 37 ], (4) Barthel index > 40[ 50 ] or > 60[ 26 ].…”

Section: Methodsmentioning

confidence: 99%

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The truths behind the statistics of surgical treatment for hypertensive brainstem hemorrhage in China: a review

2021

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The truths behind the statistics of surgical treatment for hypertensive brainstem hemorrhage in China: a review

2021

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“…Therefore, in theory, surgery carried out in the super early phase (within a 6 h time window) seems to be the best choice. According to a study by Lan et al, patients with PBSH in the early operative group (≤6 h) had a better neurologic recovery than those in the late operative group (>6 h), and this difference was statistically significant (P = 0.02) (72). However, based on their experience with 52 cases of surgical treatment, Chen et al proposed that 12-48 h after ictus may be the optimal surgical timing for PBSH (73).…”

Section: Surgical Management Guidelinesmentioning

confidence: 99%

Primary Brainstem Hemorrhage: A Review of Prognostic Factors and Surgical Management

et al. 2021

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Primary brainstem hemorrhage (PBSH) is the most fatal subtype of intracerebral hemorrhage and is invariably associated with poor prognosis. Several prognostic factors are involved, of which the two most predominant and consistent are the initial level of consciousness and hemorrhage size. Other predictors, such as age, hyperthermia, and hydrocephalus, are generally not dependable indicators for making prognoses. Scoring systems have now been developed that can predict mortality and functional outcomes in patients suffering from PBSH, which can thus guide treatment decision-making. A novel grading scale, entitled “the new primary pontine hemorrhage (PPH) score,” represents the latest approach in scoring systems. In this system, patients with a score of 2–3 points appear to benefit from surgical management, although this claim requires further verification. The four main surgical options for the treatment of PBSH are craniotomy, stereotactic hematoma puncture and drainage, endoscopic hematoma removal, and external ventricular drainage. Nevertheless, the management of PBSH still primarily involves conservative treatment methods and surgery is generally not recommended, according to current practice. However, the ongoing clinical trial, entitled Safety and Efficacy of Surgical Treatment in Severe Primary Pontine Hemorrhage Evacuation (STIPE), should provide additional evidence to support the surgical treatment of PBSH. Therefore, we advocate the update of epidemiological data and re-evaluation of PBSH treatment in a contemporary context.

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Stereotactic hematoma puncture and drainage for primary pontine hemorrhage: Clinical outcomes and predictive model

Ding,

Qi,

Zhang

et al. 2024

Heliyon

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Spontaneous hypertensive brainstem hemorrhage: Does surgery benefit the severe cases?

Cited by 13 publications

References 17 publications

The truths behind the statistics of surgical treatment for hypertensive brainstem hemorrhage in China: a review

The truths behind the statistics of surgical treatment for hypertensive brainstem hemorrhage in China: a review

Primary Brainstem Hemorrhage: A Review of Prognostic Factors and Surgical Management

Stereotactic hematoma puncture and drainage for primary pontine hemorrhage: Clinical outcomes and predictive model

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