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Colegio de Medicos y Cirujanos República de Costa Rica

2019, Number 627

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Rev Med Cos Cen 2019; 85 (627)

Actualización en el manejo de la hemorragia intracerebral espontánea

Odio ZP, Martínez ME, Huete MF, Hernández GA, Barboza EMA

Language: Spanish
References: 38
Page: 16-23
PDF size: 120.36 Kb.


ABSTRACT

Intracerebral hemorrhage stands among the main causes of disability and death worldwide, nevertheless, most management recommendations have a low level of evidence. In general, intracerebral hemorrhage management consists of the following points: avoiding intracranial hypertension and elevated blood pressure, preventing hematoma expansion, assessing surgical drainage and treating associated complications.
Management should be in a stroke unit, considering first circulatory and ventilatory stabilization. Regarding elevated blood pressure, lowering and maintenance of the systolic blood pressure below 140 mmHg is recommended. Patients on anticoagulation therapy with warfarin should have their INR reversed, preferably with prothrombin complex. Hemostatic measures lack evidence of offering beneficial effects on patients who aren’t on anticoagulation therapy.
Surgical management in intracerebral hemorrhage has always been a controversial topic. Minimally invasive surgery appears to offer a therapeutic benefit lacking in classic surgical techniques. Intraventricular thrombolysis is another potential safe therapeutic option


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