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2016, Number 2

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Rev Ciencias Médicas 2016; 20 (2)

Surgical management of primary supratentorialintraparenchymal hemorrhage

Pérez NFR, Rodríguez LM, Bermejo SJC, Hernández LO, Álvarez TN

Language: Spanish
References: 41
Page: 259-270
PDF size: 338.99 Kb.


ABSTRACT

Introduction: cerebrovascular disease is one of the leading causes of death and disability worldwide. The goal to be pursued in surgical treatment is the maximum removal of the hematoma minimizing the damage to healthy tissue. Currently there are no unanimous criteria for the surgical management of primary supratentorialintraparenchymal hemorrhage.
Objective: to conduct an update literature review on the topic, aimed at exposing the different criteria for the surgical management and to describe the best results.
Development: current indications for the surgical removal: progressive neurological deterioration, significant expansion of the hematoma, uncontrollable intracranial pressure or data of cerebral herniation. To perform an accurate surgical treatment it is essential to know its pathophysiology in order to achieve the surgical goals along with the improvement of morbidity and mortality. Currently the ideal time for the evacuation of cerebral hemorrhage appears still controversial, randomized studies have shown good results evacuating it between 4-96 hours from the onset of symptoms. In current studies good results are observed in early stages of its onset and under endoscopic support.
Conclusions: surgical management of primary intraparenchymal hemorrhage appears still controversial. The scale of intraparenchymal hemorrhage is reliable to determine the prognosis of patients. New randomized studies should be developed to determine which will be the ideal therapy to improve the quality of life once the bleeding is presented.


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