2020, Number 1
Medical-surgical treatment of supratentorial lobar spontaneous intraparenchymal hemorrhages
Language: Spanish
References: 17
Page: 1-13
PDF size: 458.44 Kb.
ABSTRACT
Introduction: spontaneous intracerebral hemorrhage is a health problem for humanity. However, the great efforts made in the field of research and therapeutics, its management constitutes a dilemma for the international medical community.Objective: to evaluate the efficacy of surgical treatment of supratentorial spontaneous lobar intracerebral hemorrhages.
Methods: a quasi-experiment was carried out with a control group at the General Teaching Hospital of Morón, Ciego de Ávila province, between March 2014 and September 2017. Two groups were created, selected without matching and intentionally according to international surgical criteria. The study population was made up of 42 patients: 24 (57,14 %) in group I who received medical treatment, and 18 in group II (48,86 %), who underwent decompressive craniectomy. The chi square independence test was used to evaluate the hypothesis (significant values of p ≤ 0,05). Ethical guidelines were fulfilled.
Results: in group I, the age group of 60 years and over predominated (61,53 %) and in group II, those from 30 to 49 years old (50.00%). High blood pressure as a risk factor occurred in 41,66 % of group I and in 38.88% of group II. 54.76% of the patients survived six months after discharge and 45,24 % died. The results were not statistically significant due to the low casuistry of the study.
Conclusions: the surgical treatment did not present a significant level of statistical evidence regarding the decrease in mortality compared to medical treatment.
REFERENCES
Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. Heart disease and stroke statistics -2010 update: a report from the American Heart Association. Circulation [Internet]. Feb 2010 [citado 7 Ene 2018];121(7):948-54. Disponible en: https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.109.192666
Dubourg J, Messerer M. State of the art in managing no traumatic intracerebral hemorrhage. Neurosurg Focus [Internet]. 2011 [citado 7 Ene 2018];30(6):[aprox. 7 p.]. Disponible en: https://www.researchgate.net/profile/Mahmoud_Messerer/publication/51182575_State_of_the_art_in_managing_nontraumatic_intracerebral_hemorrhage/links/568bc64608ae8445f58db210.pdf
Gaberel T, Magheru C, Emery E. Management of non-traumatic intraventricular hemorrhage. Neurosurg Rev [Internet]. 2012 [citado 7 Ene 2018];35(4):485-95. Disponible en: http://content.ebscohost.com/ContentServer.asp?T=P&P=AN&K=22732889&S=R&D=mdc&EbscoContent=dGJyMNLe80Seqa44yOvqOLCmsEiep7BSr6e4SrGWxWXS&ContentCustomer=dGJyMPGnr06vr7JJuePfgeyx44Dt6fIA
Lazo-Langner A, Lang ES, Douketis J. Clinical review: clinical management of new oral anticoagulants: a structured review with emphasis on the reversal of bleeding complications. Crit Care [Internet]. 2013 [citado 7 Ene 2018];17(3):[aprox. 12 p.]. Disponible en: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.800.8207&rep=rep1&type=pdf
Smith EE, Shobha N, Dai D, Olson DM, Reeves MJ, Saver JL, et al. A risk score for in-hospital death in patients admitted with ischemic or hemorrhagic stroke. J Am Heart Assoc [Internet]. 2013 [citado 7 Ene 2018];2(1):[aprox. 10 p.]. Disponible en: https://www.ahajournals.org/doi/pdf/10.1161/JAHA.112.005207
Qureshi AI, Palesch YY, Martin R, Novitzke J, Cruz-Flores S, Ehtisham A, et al. Effect of systolic blood pressure reduction on hematoma expansion, perihematomal edema, and 3-month outcome among patients with intracerebral hemorrhage. Results from the antihypertensive treatment of acute cerebral hemorrhage study. Arch Neurol [Internet]. 2010 [citado 7 Ene 2018];67(5):570-6. Disponible en: https://jamanetwork.com/journals/jamaneurology/fullarticle/800192
Delcourt C, Huang Y, Wang J, Heeley E, Lindley R, Stapf C, et al. The second (main) phase of an open, randomized, multicentre study to investigate the effectiveness of an intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT2). Int J Stroke [Internet]. 2010 [citado 7 Ene 2018];5(2):110-6. Disponible en: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1747-4949.2010.00415.x
Mendelow AD, Gregson BA, Fernández HM, Murray GD, Teasdale GM, Hope DT, 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 randomized trial. Lancet [Internet]. 2005 [citado 7 Ene 2018];365:387-97. Disponible en: http://strokenotes.pbworks.com/f/STICH1+-+Lancet.pdf
Fung C, Murek M, Z’Graggen WJ, Krähenbühl AK, Gautschi OP, Schucht P, Gralla J, et al. Decompressive hemicraniectomy in patients with supratentorial intracerebral hemorrhage. Stroke [Internet]. 2012 [citado 7 Ene 2018];43(12):3207-11. Disponible en: https://www.ahajournals.org/doi/epub/10.1161/STROKEAHA.112.666537
Lacerda-Gallardo AJ, Díaz-Agramonte JA, Martín-Pardo JC, Pérez-Leal S, Martín-Chaviano D, Abreu-Pérez D. Resultados de 11 años de tratamiento quirúrgico en las hemorragias intracerebrales lobares espontáneas supratentoriales. Rev Cubana Neurol Neurocir [Internet]. 2012 [citado 7 Ene 2018];2(2):114-20. Disponible en: http://revneuro.sld.cu/index.php/neu/article/download/40/40
Lacerda-Gallardo AJ, Díaz-Agramonte JA, Martín-Pardo JC, Martín-Chaviano D, Nieves-Torres JC, Vélez-Gómez I, et al. Evacuación quirúrgica guiada por ecografía de hemorragias intracerebrales espontáneas lobares. Rev Cubana Neurol Neurocir [Internet]. 2012 [citado 7 Ene 2018];2(2):132-5. Disponible: http://revneuro.sld.cu/index.php/neu/article/download/43/43
Hayes SB, Benveniste RJ, Morcos JJ, Aziz-Sultan MA, Elhammady MS. Retrospective comparison of craniotomy and descompressive craniectomy for surgical evacuation of non traumatic, supratentorial intracerebral hemorrhage. Neurosurg Focus [Internet]. 2013 [citado 7 Ene 2018];34(5):[aprox. 6 p.]. https://thejns.org/downloadpdf/journals/neurosurg-focus/34/5/article-pE3.pdf
Lacerda-Gallardo AJ, Hernández-Guerra O, Díaz-Agramonte JA, Pérez-Leal S, Mazorra-Pazos MJ, Abreu-Pérez D. Tratamiento quirúrgico en las hemorragias intracerebrales lobares espontáneas supratentoriales sin extensión ventricular. Rev. Chil Neurocirugía [Internet]. 2015 [citado 7 Ene 2018];41(1):45-53. Disponible en: https://www.neurocirugiachile.org/pdfrevista/v41_n1_2015/lacerdagallardo_p45_v41n1_2015.pdf