Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-30T19:22:17.790Z Has data issue: false hasContentIssue false
  • English
  • Français

Advances in intracerebral haemorrhage management

Published online by Cambridge University Press:  01 February 2008

C. S. Kase
C. S. Kase*
Affiliation:
Boston University School of Medicine, Department of Neurology, Boston, MA, USA
*
Correspondence to: Carlos S. Kase, Department of Neurology, Boston University School of Medicine, 715 Albany Street, C-338, Boston, MA 02118, USA. E-mail: [email protected]; Tel: +1 617 638 5102; Fax: +1 617 638 7758
Get access

Summary

Intracerebral haemorrhage accounts for 10–15% of strokes and is associated with high mortality and severe disability in survivors. Despite its seriousness, the treatment options for intracerebral haemorrhage are limited. Measures aimed at decreasing elevated intracranial pressure are of limited effectiveness. This has stimulated an interest in attempting to improve the prognosis of intracerebral haemorrhage by addressing the haematoma directly, either removing it by surgical means or limiting its early spontaneous growth. The international Surgical Trial in Intracerebral Haemorrhage (STICH), which randomized subjects with intracerebral haemorrhage within 72 h of symptom onset to medical management vs. surgery, failed to document the superiority of one treatment over the other, when compared with regard to mortality and functional outcome at 90 days. The subgroup of patients with lobar haematomas located at a depth of 1 cm or less from the cortical surface fared better with surgery than with medical management. A similar comparison trial is planned for this subgroup of patients. The neutral results of The international Surgical Trial in Intracerebral Haemorrhage (STICH) prompted the assessment of haemostatic therapies, based on the observation that haematomas often enlarge substantially in the hours that follow the onset of symptoms. Recombinant activated factor VII has been shown in a phase IIb, dose-finding trial to result in a significant reduction of haematoma growth, and both mortality and functional scales trended in favour of recombinant activated factor VIIa. The main complication of this therapy was arterial thromboembolic events (myocardial infarction and ischaemic stroke). A phase III randomized trial has recently been completed.

Keywords

CEREBRAL HAEMORRHAGENEUROSURGICAL PROCEDURESINTRACRANIAL PRESSURE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue S42 , February 2008 , pp. 16 - 22
Copyright
Copyright © European Society of Anaesthesiology 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Broderick, JP, Brott, T, Tomsick, T et al. . Intracerebral hemorrhage more than twice as common as subarachnoid hemorrhage. J Neurosurg 1993; 78: 188–191.CrossRefGoogle ScholarPubMed
2.Counsell, C, Boonyakarnkul, S, Dennis, M et al. . Primary intracerebral haemorrhage in the Oxfordshire community stroke project. 2: prognosis. Cerebrovasc Dis 1995; 5: 26–34.CrossRefGoogle Scholar
3.Broderick, JP, Brott, TG, Duldner, JE, Tomsick, T, Huster, G. Volume of intracerebral hemorrhage: a powerful and easy-to-use predictor of 30-day mortality. Stroke 1993; 24: 987–993.CrossRefGoogle Scholar
4.Diringer, MN, Edwards, DF, Zazulia, AR. Hydrocephalus: a previously unrecognized predictor of poor outcome from supratentorial intracerebral hemorrhage. Stroke 1998; 29: 1352–1357.CrossRefGoogle ScholarPubMed
5.Fogelholm, R, Murros, K, Rissanen, A, Avikainen, S. Admission blood glucose and short term survival in primary intracerebral haemorrhage: a population based study. J Neurol Neurosurg Psychiat 2005; 76: 349–353.CrossRefGoogle ScholarPubMed
6.Leira, R, Davalos, A, Silva, Y et al. . Early neurologic deterioration in intracerebral hemorrhage: predictors and associated factors. Neurology 2004; 63: 461–467.CrossRefGoogle ScholarPubMed
7.Alvarez-Sabin, J, Delgado, P, Abilleira, S et al. . Temporal profile of matrix metalloproteinases and their inhibitors after spontaneous intracerebral hemorrhage: relationship to clinical and radiological outcome. Stroke 2004; 35: 1316–1322.CrossRefGoogle ScholarPubMed
8.Silva, Y, Leira, R, Tejada, J et al. . Molecular signatures of vascular injury are associated with early growth of intracerebral hemorrhage. Stroke 2005; 36: 86–91.CrossRefGoogle ScholarPubMed
9.Castillo, J, Davalos, A, Alvarez-Sabin, J et al. . Molecular signatures of brain injury after intracerebral hemorrhage. Neurology 2002; 58: 624–629.CrossRefGoogle ScholarPubMed
10.Diringer, MN. Intracerebral hemorrhage: pathophysiology and management. Crit Care Med 1993; 21: 1591–1603.CrossRefGoogle ScholarPubMed
11.Adams, HP, Adams, RJ, Brott, T et al. . Guidelines for the early management of patients with ischemic stroke: a scientific statement from the Stroke Council of the American Stroke Association. Stroke 2003; 34: 1056–1083.CrossRefGoogle ScholarPubMed
12.Kazui, S, Naritomi, H, Yamamoto, H, Sawada, T, Yamaguchi, T. Enlargement of spontaneous intracerebral hemorrhage: incidence and time course. Stroke 1996; 27: 1783–1787.CrossRefGoogle ScholarPubMed
13.Brott, T, Broderick, J, Kothari, R et al. . Early hemorrhage growth in patients with intracerebral hemorrhage. Stroke 1997; 28: 1–5.CrossRefGoogle ScholarPubMed
14.Fujii, Y, Takeuchi, S, Sasaki, O, Minakawa, T, Tanaka, R. Multivariate analysis of predictors of hematoma enlargement in spontaneous intracerebral hemorrhage. Stroke 1998; 29: 1160–1166.CrossRefGoogle ScholarPubMed
15.Powers, WJ, Zazulia, AR, Videen, TO et al. . Autoregulation of cerebral blood flow surrounding acute (6 to 22 hours) intracerebral hemorrhage. Neurology 2001; 57: 18–24.CrossRefGoogle ScholarPubMed
16.Broderick, JP, Adams, HP, Barsan, W et al. . Guidelines for the management of spontaneous intracerebral hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke 1999; 30: 905–915.CrossRefGoogle ScholarPubMed
17.Hart, RG, Boop, BS, Anderson, DC. Oral anticoagulants and intracranial hemorrhage: facts and hypotheses. Stroke 1995; 26: 1471–1477.CrossRefGoogle Scholar
18.Fang, MC, Chang, Y, Hylek, EM et al. . Advanced age, anticoagulation intensity, and risk for intracranial hemorrhage among patients taking warfarin for atrial fibrillation. Ann Intern Med 2004; 141: 745–752.CrossRefGoogle ScholarPubMed
19.Schulman, S. Care of patients receiving long-term anticoagulant therapy. N Engl J Med 2003; 349: 675–683.CrossRefGoogle ScholarPubMed
20.Lankiewicz, MW, Hays, J, Friedman, KD, Tinkoff, G, Blatt, PM. Urgent reversal of warfarin with prothrombin complex concentrate. J Throm Haemost 2006; 4: 967–970.CrossRefGoogle ScholarPubMed
21.Aguilar, MI, Hart, RG, Kase, CS et al. . Treatment of warfarin-associated intracerebral hemorrhage: literature review and expert opinion. Mayo Clin Proc 2007; 82: 82–92.CrossRefGoogle ScholarPubMed
22.Deveras, RA, Kessler, CM. Reversal of warfarin-induced excessive anticoagulation with recombinant human factor VIIa concentrate. Ann Intern Med 2002; 137: 884–888.CrossRefGoogle ScholarPubMed
23.Freeman, WD, Brott, TG, Barrett, KM et al. . Recombinant factor VIIa for rapid reversal of warfarin anticoagulation in acute intracranial hemorrhage. Mayo Clin Proc 2004; 79: 1495–1500.CrossRefGoogle ScholarPubMed
24.Mayer, SA, Brun, NC, Begtrup, K et al. . Recombinant activated factor VII for acute intracerebral hemorrhage.N Engl J Med 2005; 352: 777–785.CrossRefGoogle ScholarPubMed
25.O’Connell, KA, Wood, JJ, Wise, RP, Lozier, JN, Braun, MM. Thromboembolic adverse events after use of recombinant human coagulation factor VIIa. JAMA 2006; 295: 293–298.CrossRefGoogle ScholarPubMed
26.Sugg, RM, Gonzalez, NR, Matherne, DE et al. . Myocardial injury in patients with intracerebral hemorrhage treated with recombinant factor VIIa. Neurology 2006; 67: 1053–1055.CrossRefGoogle ScholarPubMed
27.Chambers, IR, Banister, K, Mendelow, AD. Intracranial pressure within a developing intracerebral hemorrhage. Br J Neurosurg 2001; 15: 140–141.Google Scholar
28.Yu, YL, Kumana, CR, Lauder, IJ et al. . Treatment of acute cerebral hemorrhage with intravenous glycerol: a double-blind, placebo-controlled, randomized trial. Stroke 1992; 23: 967–971.CrossRefGoogle ScholarPubMed
29.Poungvarin, N, Bhoopat, W, Viriyavejakul, A et al. . Effects of dexamethasone in primary supratentorial intracerebral hemorrhage. N Engl J Med 1987; 316: 1229–1233.CrossRefGoogle ScholarPubMed
30.Schwarz, S, Hafner, K, Aschoff, A, Schwab, S. Incidence and prognostic significance of fever following intracerebral hemorrhage. Neurology 2000; 54: 354–361.CrossRefGoogle ScholarPubMed
31.Rossi, S, Zanier, ER, Mauri, I et al. . Brain temperature, body core temperature and intracranial pressure in acute cerebral damage. J Neurol Neurosurg Psychiat 2001; 71: 448–454.CrossRefGoogle ScholarPubMed
32.Schwab, S, Georgiadis, D, Berrouschot, J, Schellinger, PD, Graffagnino, C, Mayer, SA. Feasibility and safety of moderate hypothermia after massive hemispheric infarction. Stroke 2001; 32: 2033–2035.CrossRefGoogle ScholarPubMed
33.Passero, S, Rocchi, R, Rossi, R et al. . Seizures after spontaneous supratentorial intracerebral hemorrhage. Epilepsia 2002; 43: 1175–1180.CrossRefGoogle ScholarPubMed
34.Vespa, PM, O’Phelan, K, Shah, M et al. . Acute seizures after intracerebral hemorrhage: a factor in progressive midline shift and outcome. Neurology 2003; 60: 1441–1446.CrossRefGoogle ScholarPubMed
35.Stocchetti, N, Maas, AIR, Chieregato, A, van der Plas, AA. Hyperventilation in head injury: a review. Chest 2005; 127: 1812–1827.CrossRefGoogle ScholarPubMed
36.Misra, UK, Kalita, J, Ranjan, P, Mandal, SK. Mannitol in intracerebral hemorrhage: a randomized controlled study. J Neurol Sci 2005; 234: 41–45.CrossRefGoogle ScholarPubMed
37.Wijman, CAC, Kase, CS. Intracerebral hemorrhage: medical considerations. In: Barnett, HJM, Mohr, JP, Stein, BM, Yatsu, FM, eds. Stroke: Pathophysiology, Diagnosis, and Management, 3rd edn. New York, USA: Churchill Livingstone Inc., 1998: 1359–1372.Google Scholar
38.Schwab, S, Spranger, M, Schwarz, S, Hacke, W. Barbiturate coma in severe hemispheric stroke: useful or obsolete? Neurology 1997; 48: 1608–1613.CrossRefGoogle ScholarPubMed
39.Lozier, AP, Sciacca, RR, Romagnoli, MF et al. . Ventriculostomy-related infections: a critical review of the literature. Neurosurgery 2002; 51: 170–181.CrossRefGoogle ScholarPubMed
40.Halloway, KL, Barnes, T, Choi, S et al. . Ventriculostomy infections: the effect of monitoring duration and catheter exchange in 584 patients. J Neurosurg 1996; 85: 419–424.CrossRefGoogle Scholar
41.Schade, RP, Schinkel, J, Visser, LG, Van Dijk, JM, Voormolen, JH, Kuijper, EJ. Bacterial meningitis caused by the use of ventricular or lumbar cerebrospinal fluid catheters. J Neurosurg 2005; 102: 229–234.CrossRefGoogle ScholarPubMed
42.McKissock, W, Richardson, A, Taylor, J. Primary intracerebral haemorrhage: a controlled trial of surgical and conservative treatment in 180 unselected cases. Lancet 1961; 2: 221–226.CrossRefGoogle Scholar
43.Juvela, S, Heiskanen, O, Poranen, A et al. . The treatment of spontaneous intracerebral hemorrhage: a prospective randomized trial of surgical and conservative treatment. J Neurosurg 1989; 70: 755–758.CrossRefGoogle ScholarPubMed
44.Batjer, HH, Reisch, JS, Allen, BC et al. . Failure of surgery to improve outcome in hypertensive putaminal hemorrhage: a prospective randomized trial. Arch Neurol 1990; 47: 1103–1106.CrossRefGoogle ScholarPubMed
45.Morgenstern, LB, Frankowski, RF, Shedden, P et al. . Surgical treatment for intracerebral hemorrhage (STICH): a single-center, randomized clinical trial. Neurology 1998; 51: 1359–1363.CrossRefGoogle Scholar
46.Zuccarello, M, Brott, T, Derex, L et al. . Early surgical treatment for supratentorial intracerebral hemorrhage: a randomized feasibility study. Stroke 1999; 30: 1833–1839.CrossRefGoogle ScholarPubMed
47.Auer, LM, Deinsberger, W, Niederkorn, K et al. . Endoscopic surgery versus medical treatment for spontaneous intracerebral hematoma: a randomized study. J Neurosurg 1989; 70: 530–535.CrossRefGoogle ScholarPubMed
48.Teernstra, OPM, Evers, SMAA, Lodder, J, Leffers, P, Franke, CL, Blaauw, G. Stereotactic Treatment of Intracerebral Hematoma by Means of a Plasminogen Activator: a Multicenter Randomized Controlled Trial (SICHPA). Stroke 2003; 34: 968–974.CrossRefGoogle ScholarPubMed
49.Hattori, N, Katayama, Y, Maya, Y, Gatherer, A. Impact of stereotactic hematoma evacuation on activities of daily living during the chronic period following spontaneous putaminal hemorrhage: a randomized study. J Neurosurg 2004; 101: 417–420.CrossRefGoogle ScholarPubMed
50.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: 387–397.CrossRefGoogle Scholar
51.Rabinstein, AA, Wijdicks, EFM. Surgery for intracerebral hematoma: the search for the elusive right candidate. Rev Neurol Dis 2006; 3: 163–172.Google ScholarPubMed
52.Earnshaw, SR, Joshi, AV, Wilson, MR, Rosand, J. Cost-effectiveness of recombinant activated factor VII in the treatment of intracerebral hemorrhage. Stroke 2006; 37: 2751–2758.CrossRefGoogle ScholarPubMed
53.Broderick, JP. The STICH trial: what does it tell us and where do we go from here? Stroke 2005; 36: 1619–1620.CrossRefGoogle Scholar