Dave Fiorella1, Scott L Zuckerman2, Imad S Khan3, Nishant Ganesh Kumar4, J Mocco5. 1. Department of Neurological Surgery, Stony Brook University Medical Center, Stony Brook, New York, USA. 2. Department of Neurological Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA. Electronic address: scott.zuckerman@vanderbilt.edu. 3. Section of Neurosurgery, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA. 4. Department of Neurological Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA. 5. Department of Neurological Surgery, The Mt. Sinai Hospital, New York, New York, USA.
Abstract
OBJECTIVE: To review the poor natural history of intracerebral hemorrhage (ICH), current treatment options for ICH, discuss ongoing trials evaluating minimally invasive techniques for clot evacuation, and offer future directions of investigation for the management of this devastating disease. METHODS: A selective review of recent trials regarding treatment of ICH was performed. RESULTS: Completed trials of medical and surgical management are reviewed. The supportive research for clot evacuation to limit secondary injury is surveyed. We also provide a comprehensive discussion of current data evaluating minimally invasive techniques to achieve clot removal, including Minimally Invasive Surgery plus tPA for ICH Evacuation (MISTIE), Clot Lysis: Evaluating Accelerated Resolution (CLEAR), and endoscopic evacuation. CONCLUSION: We encourage the neurosurgical community to pursue improved therapies for ICH. PRACTICE: New minimally invasive treatments for ICH are being developed. IMPLICATIONS: Treatment of ICH is an important area of research and should continue to be aggressively pursued because of the significant societal burden and poor outcomes associated with ICH.
OBJECTIVE: To review the poor natural history of intracerebral hemorrhage (ICH), current treatment options for ICH, discuss ongoing trials evaluating minimally invasive techniques for clot evacuation, and offer future directions of investigation for the management of this devastating disease. METHODS: A selective review of recent trials regarding treatment of ICH was performed. RESULTS: Completed trials of medical and surgical management are reviewed. The supportive research for clot evacuation to limit secondary injury is surveyed. We also provide a comprehensive discussion of current data evaluating minimally invasive techniques to achieve clot removal, including Minimally Invasive Surgery plus tPA for ICH Evacuation (MISTIE), Clot Lysis: Evaluating Accelerated Resolution (CLEAR), and endoscopic evacuation. CONCLUSION: We encourage the neurosurgical community to pursue improved therapies for ICH. PRACTICE: New minimally invasive treatments for ICH are being developed. IMPLICATIONS: Treatment of ICH is an important area of research and should continue to be aggressively pursued because of the significant societal burden and poor outcomes associated with ICH.
Authors: Audrey Leasure; W Taylor Kimberly; Lauren H Sansing; Kristopher T Kahle; Golo Kronenberg; Hagen Kunte; J Marc Simard; Kevin N Sheth Journal: Curr Treat Options Neurol Date: 2016-02 Impact factor: 3.598
Authors: Paulo Henrique Rosado-de-Castro; Felipe Gonçalves de Carvalho; Gabriel Rodriguez de Freitas; Rosalia Mendez-Otero; Pedro Moreno Pimentel-Coelho Journal: Stem Cells Int Date: 2016-09-06 Impact factor: 5.443