for Brain Hemorrhage: A Multicenter Randomized Controlled Trial [Original Contribution]: Background and Purpose—
Intracerebral hemorrhage (ICH) is a devastating disease without a proven therapy to improve long-term outcome. Considerable controversy about the role of surgery remains. Minimally invasive endoscopic surgery for ICH offers the potential of improved neurological outcome.
Methods—
We tested the hypothesis that intraoperative computerized tomographic image–guided endoscopic surgery is safe and effectively removes the majority of the hematoma rapidly. A prospective randomized controlled study was performed on 20 subjects (14 surgical and 4 medical) with primary ICH of >20 mL volume within 48 hours of ICH onset. We prospectively used a contemporaneous medical control cohort (n=36) from the MISTIE trial (Minimally Invasive Surgery and r-tPA for ICH Evacuation). We evaluated surgical safety and neurological outcomes at 6 months and 1 year.
Results—
The intraoperative computerized tomographic image–guided endoscopic surgery procedure resulted in immediate reduction of hemorrhagic volume by 68±21.6% (interquartile range 59–84.5) within 29 hours of hemorrhage onset. Surgery was successfully completed in all cases, with a mean operative time of 1.9 hours (interquartile range 1.5–2.2 hours). One surgically related bleed occurred peri-operatively, but no patient met surgical safety stopping threshold end points for intraoperative hemorrhage, infection, or death. The surgical intervention group had a greater percentage of patients with good neurological outcome (modified Rankin scale score 0–3) at 180 and 365 days as compared with medical control subjects (42.9% versus 23.7%; P=0.19).
Conclusions—
Early computerized tomographic image–guided endoscopic surgery is a safe and effective method to remove acute intracerebral hematomas, with a potential to enhance neurological recovery.
Clinical Trial Registration—
URL: http://ift.tt/PmpYKN. Unique identifier: NCT00224770.
http://ift.tt/2dzATlf
Ιατρική : Τα αισθητικά συστήματα της όρασης,ακοής,αφής,γεύσης και όσφρησης.
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Publication date: April 2017 Source: European Journal of Vascular and Endovascular Surgery, Volume 53, Issue 4 http://ift.tt/2oUTFL8 ...
-
Related Articles Identification of somatic TERT promoter mutations in familial non-medullary thyroid carcinomas (FNMTC). Clin Endocri...
-
Correlation Between the Epworth Sleepiness Scale and the Maintenance of Wakefulness Test in Patients With Narcolepsy Participating in Two Cl...
-
The Role of KIT Mutations in Anaphylaxis Abstract Purpose of Review Gain of function KIT mutations are detected in clonal mast cell diseases...
-
AbstractBackground Little is known about patterns of medication use and lifestyle counseling in patients with peripheral artery disease (PA...
-
# Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174, alsfakia@gmail.com , T...
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου