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首页> 外文期刊>The Egyptian Journal of Neurology, Psychiatry and Neurosurgery >Early outcome of Conservative versus Surgical Treatment of Spontaneous Supratentorial Intracerebral Hemorrhage
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Early outcome of Conservative versus Surgical Treatment of Spontaneous Supratentorial Intracerebral Hemorrhage

机译：保守性与手术治疗自发性上腔内脑出血的早期结果

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Background: Spontaneous supratentorial intracerebral hemorrhage (ICH) is one of the most severe types of stroke. The decision about whether and when to surgically remove ICH remains controversial. Early surgery to limit the mechanical compression of brain and the toxic effects of blood may limit injury. Objective:  To investigate the early outcome and effectiveness of surgery as compared with conservative medical treatment in supratentorial intracerebral hemorrhage. Methods: Forty Patients with supratentorial spontaneous ICH was assigned to surgical or best medical treatment. Twenty patients underwent surgical evacuation while twenty were received conservative medical therapy. A history and examination, including an assessment by Glasgow Coma Scale (GCS) and of the neurological status by the National Institutes of Health Stroke Scale (NIHSS), were obtained at the time of admission and after one month. Glasgow outcome scale (GOS) was performed after one month. Results: There were no statistically significant differences in GOS, GCS or NIHSS after one month of treatment (p0.05). There was 15% mortality each group with no statistically significant difference (p0.05). Patients with baseline GCS ≥9 had a better final GCS (p=0.035) in the conservative compared to surgical groups but no significant difference in final NIHSS or GOS (p0.05). Conclusion: we conclude that surgical evacuation of supratentorial intracerebral has a limited benefit compared to conservative medical treatment. It may be considered in large hematomas (80cc) with moderate impairment of conscious level. Initial GCS is better than NIHSS in the prediction of outcome and mortality.  [Egypt J Neurol Psychiat Neurosurg.  2011; 48(1): 85-92]
机译：背景：自发性幕上脑出血（ICH）是最严重的中风类型之一。关于是否以及何时以手术方式去除ICH的决定仍存在争议。早期手术以限制大脑的机械压迫和血液的毒性作用可能会限制受伤。目的：探讨与保守药物治疗相比，幕上脑内出血的早期手术结果和有效性。方法：40例幕上自发性ICH患者被分配为手术或最佳药物治疗。 20例患者接受了手术疏散，而20例接受了保守的药物治疗。在入院时和一个月后，获得了病史和体格检查，包括通过格拉斯哥昏迷量表（GCS）进行的评估以及通过美国国立卫生研究院卒中量表（NIHSS）对神经系统状况的评估。一个月后进行格拉斯哥结局量表（GOS）。结果：治疗一个月后，GOS，GCS或NIHSS的差异无统计学意义（p> 0.05）。每组的死亡率为15％，差异无统计学意义（p> 0.05）。与手术组相比，基线GCS≥9的患者在保守治疗中具有更好的最终GCS（p = 0.035），但最终NIHSS或GOS差异无统计学意义（p> 0.05）。结论：我们得出的结论是，与保守医学治疗相比，幕上脑室内外科手术撤离的益处有限。可在意识水平中等受损的大血肿（> 80cc）中考虑使用。初始GCS在预后和死亡率方面优于NIHSS。 [埃及J Neurol精神病神经外科。 2011; 48（1）：85-92]

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