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      Hémorragie cérébrale supratentorielle spontanée: quelle place pour un traitement chirurgical?

      , , , , , , ,
      Neurochirurgie
      Elsevier BV

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          Abstract

          Until very recently, no specific therapies have been demonstrated to improve outcome after spontaneous intracerebral haemorrhage (ICH). The STICH (surgical treatment for intracerebral haemorrhage) study showed no overall benefit from early surgery when compared with initial conservative treatment. In contrast, the stereotactic aspiration technique can be safely performed and in a uniform manner. Despite the reduction of ICH volume, no improvement in mortality and functional result was obtained. Endoscopy is a new therapeutic option for ICH with good results for hematoma removal. Based on these feasibility studies, a randomized control trial regarding this procedure would be required to assess the efficacy of this procedure. Due to the lack of benefit observed in the recent STICH trial, emergency surgical evacuation should be reserved for patients with large lobar haemorrhage, mass effect and rapidly deteriorating clinical condition.

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          Author and article information

          Journal
          Neurochirurgie
          Neurochirurgie
          Elsevier BV
          00283770
          June 2007
          June 2007
          : 53
          : 2-3
          : 58-65
          Article
          10.1016/j.neuchi.2006.12.003
          17445841
          484b145f-6e4c-48de-88cd-822052d1d18c
          © 2007

          https://www.elsevier.com/tdm/userlicense/1.0/

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