Document Detail

Spontaneous intracerebral haemorrhage in adults: a literature overview.
MedLine Citation:
PMID:  18176774     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A large number of reports have analysed epidemiology, pathogenesis, symptomatology, diagnostics and options for medical and surgical treatment of intracerebral haemorrhage. Nevertheless, management still remains controversial. The purpose of the present review is to summarise the clinical data and derive a current updated management concept as a result. METHODS: The analysis was based on a Medline search to November 2006 for the term "intracerebral haemorrhage" (ICH). The clinical query functions were optimised for aetiology, diagnosis and therapy to limit the results. A total of 103 articles were found eligible for review. FINDINGS: Race, age and sex influence the occurrence of ICH. Moreover, hypertension and alcohol consumption are the paramount risk factors. The most frequent pathophysiological mechanism of ICH seems to be a degenerative vessel wall change and, in consequence, rupture of small penetrating arteries and arterioles of 50-200 microm in diameter. The symptomatology depends on the size of ICH, possible rebleeding and the occurrence of hydrocephalus or seizures. The outcome is worse with concomitant occurrence of intraventricular haemorrhage. Treatment with recombinant factor VIIa (rFVIIa) within four hours after the onset of ICH limits the growth of haematoma, reduces mortality and improves functional outcome. Minimally invasive surgery tends to improve functional outcome. CONCLUSION: A systematic knowledge of currently available data on epidemiology, pathogenesis and symptomatology, the use of diagnostics and the different conservative and surgical treatment options can lead to a balanced management strategy for patients with ICH.
D Hänggi; H-J Steiger
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Publication Detail:
Type:  Comparative Study; Journal Article; Review     Date:  2008-01-08
Journal Detail:
Title:  Acta neurochirurgica     Volume:  150     ISSN:  0942-0940     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-17     Completed Date:  2008-04-14     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  371-9; discussion 379     Citation Subset:  IM    
Department of Neurosurgery, University Hospital, Heinrich-Heine-University, Düsseldorf, Germany.
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MeSH Terms
Cerebral Hemorrhage / diagnosis,  epidemiology,  etiology,  therapy*
Cross-Sectional Studies
Factor VIIa / therapeutic use
Outcome and Process Assessment (Health Care)
Recombinant Proteins / therapeutic use
Risk Factors
Surgical Procedures, Minimally Invasive
Treatment Outcome
Reg. No./Substance:
0/Recombinant Proteins; EC VIIa

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