Hemicraniectomy for Supratentorial Primary Intracerebral Hemorrhage: A Retrospective, Propensity Score Matched Study

Gildersleeve, Kasey; Hirzallah, Mohammad I.; Esquenazi, Yoshua; Moomaw, Charles J.; Sekar, Padmini; Cai, Chunyan; Tandon, Nitin; Woo, Daniel; Gonzales, Nicole R.

doi:10.1016/j.jstrokecerebrovasdis.2019.104361

Cited by 12 publications

(11 citation statements)

References 20 publications

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“…The majority of studies examine patients in a coma (GCS score <8), with hematomas >30 mL, or with ICP that did not normalize with medical management. 454,458,462,463,465,466,468,471 Many include patients within 24 hours of hemorrhage. Overall, the studies suggest that surgery may improve mortality compared with medical management.…”

Section: Surgical Interventionsmentioning

confidence: 99%

“…In patients with supratentorial ICH who are in a coma, have large hematomas with significant midline shift, or have elevated ICP refractory to medical management, decompressive craniectomy with or without hematoma evacuation may be considered to reduce mortality. [453][454][455][456][457][458][459][460] 2b C-LD 2. In patients with supratentorial ICH who are in a coma, have large hematomas with significant midline shift, or have elevated ICP refractory to medical management, effectiveness of decompressive craniectomy with or without hematoma evacuation to improve functional outcomes is uncertain.…”

Section: Cor Loe Recommendations 2b C-ldmentioning

confidence: 99%

“…Therefore, decompressive craniectomy is often considered as a lifesaving procedure despite a lack of strong randomized evidence. This guideline is based primarily on data from small RCTs, 458,462 retrospective ser ies, [453][454][455][456][457]461,[463][464][465][466][467][468][469][470][471] a systematic review, 459 and a metaanalysis. 460 These studies compared decompressive craniectomy with medical management or craniotomy with clot evacuation.…”

Section: Cor Loe Recommendations 2b C-ldmentioning

confidence: 99%

See 2 more Smart Citations

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

Greenberg¹,

Ziai²,

Cordonnier³

et al. 2022

Stroke

562

472

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other entities (RWI) can be found at https://professional. heart.org/-/media/phd-files/guidelines-and-statements/ policies-devolopment/aha-asa-disclosure-rwi-policy-5118. pdf?la=en.Beginning in 2017, numerous modifications to AHA/ ASA guidelines have been implemented to make guidelines shorter and enhance user-friendliness. Guidelines are written and presented in a modular knowledge chunk format; each chunk includes a table of recommendations, a brief synopsis, recommendation-specific supportive text, and, when appropriate, flow diagrams or additional tables. Hyperlinked references are provided to facilitate quick access and review. Other modifications to the guidelines include the addition of Knowledge Gaps and Future Research segments in some sections and a web guideline supplement (Online Data Supplement) for useful but noncritical tables and figures.

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Section: Surgical Interventionsmentioning

confidence: 99%

Section: Cor Loe Recommendations 2b C-ldmentioning

confidence: 99%

Section: Cor Loe Recommendations 2b C-ldmentioning

confidence: 99%

See 1 more Smart Citation

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

Greenberg¹,

Ziai²,

Cordonnier³

et al. 2022

Stroke

562

472

View full text Add to dashboard Cite

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“…Major therapeutic advances have occurred in the past decade, including the development of dedicated stroke units, the introduction of reperfusion therapy and interventional neuroradiology, and the performance of acute neurosurgical interventions in selected patients [ 2 – 4 ]. In clinical trials, these treatments decreased mortality and improved disability-free survival [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of patients admitted to the ICU for acute stroke: a retrospective cohort

et al. 2022

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Background Although acute stroke is a leading cause of morbidity and mortality worldwide, data on outcomes of stroke patients requiring ICU admission are limited. We aimed to identify factors associated with a good neurological outcome (defined as a modified Rankin Scale score [mRS] of 0–2) 6 months after ICU admission. Methods We retrospectively studied consecutive patients who were admitted to the ICU of a French university-affiliated hospital between January 2014 and December 2018 and whose ICD-10 code indicated acute stroke. Patients with isolated subarachnoid hemorrhage or posttraumatic stroke were excluded. Results The 323 identified patients had a median age of 67 [54.5–77] years; 173 (53.6%) were male. The main reasons for ICU admission were neurological failure (87%), hemodynamic instability (28.2%), acute respiratory failure (26%), and cardiac arrest (5.3%). At ICU admission, the Glasgow Coma Scale score was 6 [4–10] and the SAPSII was 54 [35–64]. The stroke was hemorrhagic in 248 (76.8%) patients and ischemic in 75 (23.2%). Mechanical ventilation was required in 257 patients (79.6%). Six months after ICU admission, 61 (19.5%) patients had a good neurological outcome (mRS, 0–2), 50 (16%) had significant disability (mRS, 3–5), and 202 (64.5%) had died; 10 were lost to follow-up. By multivariable analysis, factors independently associated with not having an mRS of 0–2 at 6 months were older age (odds ratio, 0.93/year; 95% confidence interval, 0.89–0.96; P < 0.01) and lower Glasgow Coma Scale score at ICU admission (odds ratio, 1.23/point; 95% confidence interval, 1.07–1.40; P < 0.01). Conclusions Acute stroke requiring ICU admission carried a poor prognosis, with less than a fifth of patients having a good neurological outcome at 6 months. Age and depth of coma independently predicted the outcome.

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“…Despite an increasing number of studies, controversy persists concerning the benefit of surgical evacuation compared to conservative treatment of ICH [ 3 ]. Large clinical trials, such as the Surgical Trial in Intracerebral Hemorrhage (STICH I and STICH II) or the Minimally Invasive Surgery Plus Recombinant Tissue-Type Plasminogen Activator for Intracerebral Hemorrhage Evacuation (MISTIE), failed to prove the clear advantage of either surgical strategies such as evacuation via a craniotomy hemicraniectomy or less invasive, catheter-directed lysis therapy by fibrinolytic drugs on long-term functional outcome [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

The Influence of Oxidative Stress on Neurological Outcomes in Spontaneous Intracerebral Hemorrhage

et al. 2021

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Spontaneous intracerebral hemorrhage (ICH) causes, besides the primary brain injury, a secondary brain injury (SBI), which is induced, amongst other things, by oxidative stress (OS) and inflammation, determining the patient’s outcome. This study aims to assess the impact of OS in plasma and cerebrospinal fluid (CSF) on clinical outcomes in patients with ICH. A total of 19 ICH (volume > 30 cc) patients and 29 control patients were included. From day one until seven, blood and CSF samples were obtained, and ICH volume was calculated. OS markers, like malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione-sulfhydryl (GSH), and the total antioxidant status (TAS) were measured. Clinical data on treatment and outcome were determined. Patients with mRS ≤ 4 showed significantly elevated SOD and GSH-Px levels in plasma compared to patients with poor CO (p = 0.004; p = 0.002). Initial increased TAS in plasma and increased MDA in CSF were linked to an unfavorable outcome after six months (p = 0.06, r = 0.45; p = 0.05, r = 0.44). A higher ICH volume was associated with a worse outcome at week six (p = 0.04, r = 0.47). OS plays a significant role in SBI. Larger ICHs, elevated MDA in CSF, and TAS in plasma were associated with a detrimental outcome, whereas higher plasma-SOD and -GSH-Px were associated with a favorable outcome.

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Hemicraniectomy for Supratentorial Primary Intracerebral Hemorrhage: A Retrospective, Propensity Score Matched Study

Cited by 12 publications

References 20 publications

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

Outcomes of patients admitted to the ICU for acute stroke: a retrospective cohort

The Influence of Oxidative Stress on Neurological Outcomes in Spontaneous Intracerebral Hemorrhage

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