Document Detail


The optimal time-window for surgical treatment of spontaneous intracerebral hemorrhage: result of prospective randomized controlled trial of 500 cases.
MedLine Citation:
PMID:  19066100     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this clinical study was to determine the optimal time-window for surgical treatment of spontaneous intracerebral hemorrhage (ICH). From January 1998 to September 2000, 17 hospitals in Shanghai participated in a prospective randomized controlled trial. Among a consecutive series of 500 patients with spontaneous ICH, 234 underwent medical treatment and 266 patients received surgical treatment. According to the interval from initial onset to treatment, they were divided into 3 stages: ultra-early (< or =7 h), early (7-24 h), and delayed (> 24 h). Perioperative evaluation (Glasgow Outcome Score), long-term outcome (the activities of daily living [ADL] score), mortality, as well as incidence of associated complications were compared respectively. We found that: a) in the ultra-early and early stages, both the perioperative and long-term outcome of surgical treatment was definitely better than medical treatment; b) for the outcome of surgical treatment, there was no significant difference between ultra-early and early stages; c) in ultra-early stage, risk of postoperative rebleeding was significantly higher, and decreased henceforth; d) in delayed stage, incidence of associated respiratory, urinary, and gastrointestinal system complications was higher in surgery group than in medication group. In summary, our study yielded conclusive evidence that the early stage (within 7-24 h) was the optimal time-window for surgical intervention of spontaneous ICH.
Authors:
Y F Wang; J S Wu; Y Mao; X C Chen; L F Zhou; Y Zhang
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta neurochirurgica. Supplement     Volume:  105     ISSN:  0065-1419     ISO Abbreviation:  Acta Neurochir. Suppl.     Publication Date:  2008  
Date Detail:
Created Date:  2008-12-10     Completed Date:  2009-04-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100962752     Medline TA:  Acta Neurochir Suppl     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  141-5     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Adolescent
Adult
Aged
Cerebral Hemorrhage / mortality,  rehabilitation,  surgery*
Chi-Square Distribution
Child
Female
Glasgow Outcome Scale
Humans
Longitudinal Studies
Male
Middle Aged
Neurosurgical Procedures / methods*
Retrospective Studies
Time Factors
Treatment Outcome
Young Adult

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