Document Detail


Acute treatment of hypertensive intracerebral hemorrhage.
MedLine Citation:
PMID:  20848325     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Hypertensive intracerebral hemorrhage remains an entity in search of definitive treatment. It requires management in a specialized unit, where hypertension, hyperglycemia, seizures, and elevated intracranial pressure can be expertly managed. However, the exact target range of hypertensive therapy is uncertain. Extraventricular drainage and surgery for cerebellar hemorrhage can both be life-saving. The role of craniotomy for hematoma resection remains unclear. Surgery for deep or pontine hemorrhages has questionable value. The reduction of clot expansion acutely may lead to improved outcomes. One option to this end, the tight control of hypertension acutely, may be difficult to prove effective. Another, the use of factor VIIa, eluded validation in one trial. Efforts are under way to reduce intraventricular hemorrhage, and with it, hydrocephalus. The role of clot evacuation in the subset of individuals with lobar hemorrhage is also being studied. In all likelihood, the key to acute treatment of this condition will be early intervention, with implementation of blood pressure control, administration of clotting factors in the emergency department, or both. This treatment will be followed by transfer to a specialized unit, with appropriate interventions in selected patients. However, morbidity and mortality will remain high, pointing out the importance of prevention through management of hypertension.
Authors:
Thomas Mirsen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current treatment options in neurology     Volume:  12     ISSN:  1534-3138     ISO Abbreviation:  Curr Treat Options Neurol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-10     Completed Date:  2011-11-10     Revised Date:  2013-07-25    
Medline Journal Info:
Nlm Unique ID:  9815940     Medline TA:  Curr Treat Options Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  504-17     Citation Subset:  -    
Affiliation:
Division of Neurology, Cooper University Hospital-UMDNJ, 3 Cooper Plaza, Suite 320, Camden, NJ, 08103, USA, mirsen-tom@cooperhealth.edu.
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