Abstract
Intracerebral hemorrhage (ICH) is one of the most common classes of stroke. Indications for surgery in patients with ICH are largely dependent on patient age, level of consciousness, time elapsed since ICH onset, and the site and size of hemorrhage; however, research in ICH approach, management, surgical indications, and technical management have not completely addressed some of the most common complications of this condition. In this chapter we review the efficacy of craniotomy and hematoma evacuation in various presentations following ICH. We also discuss current guidelines by which endoscopic evacuation can be considered, conclusions from a number of trials involving stereotactic catheter aspiration with fibrinolytic agents, and the use of decompressive craniectomy. We conclude that the standard of care should continue to be refined as new evidence becomes available, specifically that which is concerned with hemorrhage type and location.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
van Asch CJ, Luitse MJ, Rinkel GJ, et al. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol. 2010;9:167–76.
Balami JS, Buchan AM. Complications of intracerebral haemorrhage. Lancet Neurol. 2012;11:101–18.
Anderson CS, Chakera TM, Stewart-Wynne EG, et al. Spectrum of primary intracerebral haemorrhage in Perth, Western Australia, 1989-90: incidence and outcome. J Neurol Neurosurg. 1994;57:936–40.
Hanley DF. Intracerebral haemorrhage. Lancet. 2011;373:1632–44.
Rennert RC, Signorelli JW, Abraham P, et al. Minimally invasive treatment of intracerebral hemorrhage. Expert Rev Neurother. 2015;15:919–33.
Hemphill JC, Greenberg SM, Anderson CS, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015;46:2032–60.
Prasad K, Mendelow AD, Gregson B. Surgery for primary supratentorial intracerebral haemorrhage. Cochrane Database Syst Rev. 2008;8:CD000200.
Mendelow AD, Gregson BA, Fernandes HM, et al. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trial. Lancet. 2005;365:387–97.
Broderick JP. The STICH trial: what does it tell us and where do we go from here? Stroke. 2005;36:1619–20.
Mendelow AD, Gregson BA, Rowan EN, et al. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial. Lancet. 2013;382:397–408.
Kim JE, Ko SB, Kang HS, et al. Clinical practice guidelines for the medical and surgical management of primary intracerebral hemorrhage in Korea. J Korean Neurosurg Soc. 2014;56:175–87.
Vespa P, Hanley D, Betz J, et al. ICES (Intraoperative Stereotactic Computed Tomography-Guided Endoscopic Surgery) for brain hemorrhage. Stroke. 2016;47:2749–55.
Zhou H, Zhang Y, Liu L, et al. Minimally invasive stereotactic puncture and thrombolysis therapy improves long-term outcome after acute intracerebral hemorrhage. J Neurol. 2011;258:661–9.
Hanley DF, Thompson RE, Muschelli J, et al. Safety and efficacy of minimally invasive surgery plus alteplase in intracerebral haemorrhage evacuation (MISTIE): a randomised, controlled, open-label, phase 2 trial. Lancet Neurol. 2016;15:1228–37.
Fung C, Murek M, Klinger-Gratz PP, et al. Effect of decompressive craniectomy on perihematomal edema in patients with intracerebral hemorrhage. PLoS One. 2016;11:4–12.
Fung C, Murek M, Z’Graggen WJ, et al. Decompressive hemicraniectomy in patients with supratentorial intracerebral hemorrhage. Stroke. 2012;43:3207–11.
Satter A, Islam M, Haque M, et al. Comparison between decompressive craniectomy with durotomy and conservative treatment in spontaneous supratentorial intracerebral hemorrhage. Mymensingh Med J. 2016;25:316–25.
Steiner T, Al-Shahi Salman R, Beer R, et al. European stroke organisation (ESO) guidelines for the management of spontaneous intracerebral hemorrhage. Int J Stroke. 2014;9:840–55.
Morgenstern LB, Demchuk AM, Kim DH, et al. Rebleeding leads to poor outcome in ultra-early craniotomy for intracerebral hemorrhage. Neurology. 2001;56:1294–9.
Broderick J, Connolly S, Feldmann E, et al. Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: a guideline from the American Heart Association/American Stroke Association stroke council, high blood pressure research council, and the quality of care and out. Stroke. 2007;38:2001–23.
de Oliveira Manoel AL, Goffi A, Zampieri FG, et al. The critical care management of spontaneous intracranial hemorrhage: a contemporary review. Crit Care. 2016;20:272.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer Science+Business Media Singapore
About this chapter
Cite this chapter
Pucci, J.U., Mehta, S.H., Christophe, B.R., Connolly, E.S. (2018). Principles and Techniques of Surgical Management of ICH. In: Lee, SH. (eds) Stroke Revisited: Hemorrhagic Stroke. Stroke Revisited. Springer, Singapore. https://doi.org/10.1007/978-981-10-1427-7_11
Download citation
DOI: https://doi.org/10.1007/978-981-10-1427-7_11
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-10-1426-0
Online ISBN: 978-981-10-1427-7
eBook Packages: MedicineMedicine (R0)