Background: Outcomes regarding the conventional surgical and conservative treatment for the lobar intracerebral hemorrhage (ICH) have not been previously compared. The current meta-analysis was designed to review and compile the evidence regarding the management of patients with lobar intracerebral hemorrhage.
Methods: Online electronic databases, including PubMed, Embase, Medline, Cochrane Library, and Google Scholar, were searched for randomized controlled trials (RCTs). Studies were selected on the basis of the inclusion and exclusion criteria. Trials with CT-confirmed lobar intracerebral hemorrhage patients of which treatment regimen was started within 72 h following the stroke were included. Low quality trials were excluded. Death or dependence was defined as primary outcome and death at the end of the follow up was the secondary outcome.
Results: One hundred five RCTs were screened and 96 articles were excluded on the basis of abstract. Nine articles were assessed for the eligibility and 7 trials were included that involved 1,102 patients. The Odds ratio (OR) for the primary outcome was 0.80 (95% CI, 0.62-1.04, = 0.09) and for the secondary outcome was 0.79 (95%CI, 0.60-1.03, = 0.09).
Conclusion: Our findings suggested that surgical treatments did not significantly improve the functional outcome as compared with the conservative medical management for patients with lobar ICH.
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http://dx.doi.org/10.3389/fneur.2021.742959 | DOI Listing |
J Cereb Blood Flow Metab
January 2025
McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA.
Spontaneous intracerebral hemorrhage(ICH) represents a life-threatening form of stroke, marked by its impact on survival and quality of life. ICH can be categorized from monogenic disorders linked to causal germline variants in ICH-related genes to complex sporadic cases, highlighting the interaction among lifestyle factors, environmental influences, and genetic components in determining risk. Among sporadic ICH, the influence of these factors varies across ICH subtypes, evidenced by heritability rates of up to 73% for lobar ICH versus 34% for non-lobar ICH.
View Article and Find Full Text PDFStroke
January 2025
University of Lille, INSERM, CHU Lille, U1172- Lille Neuroscience and Cognition, France (C.C.).
After 30 years of disappointment, 2 randomized controlled trials investigating the effect of neurosurgical treatment on functional outcome in patients with intracerebral hemorrhage were published in 2024. The ENRICH trial (Early Minimally Invasive Removal of Intracerebral Hemorrhage) studied the efficacy of early minimally invasive hematoma removal in patients with lobar or anterior basal ganglia intracerebral hemorrhage, whereas the SWITCH trial investigated the effect of decompressive craniectomy without hematoma removal in severe deep intracerebral hemorrhage. In this critique article, we will discuss the main findings of these trials, their implications and future perspectives.
View Article and Find Full Text PDFCurr Neurovasc Res
December 2024
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Jpn J Radiol
December 2024
Department of Radiology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan.
Cerebral amyloid angiopathy (CAA) is an age-related small vessel disease pathologically characterized by the progressive accumulation of amyloid-beta (Aβ) peptide in cerebrovascular walls, affecting both cortical and leptomeningeal vessels. Amyloid deposition results in fragile vessels, which may lead to lobar intracerebral hemorrhage (ICH) and cognitive impairment. To evaluate the probability and severity of CAA, the imaging markers depicted on CT and MRI techniques are crucial, as brain pathological examination is highly invasive.
View Article and Find Full Text PDFJ Multidiscip Healthc
December 2024
Department of Thoracic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot City, Inner Mongolia, People's Republic of China.
Objective: To analyze the differences in cerebral microbleeds (CMBs) and their correlation with intracerebral hemorrhage (ICH) in Mongolian and Han Chinese patients with ischemic cerebrovascular disease.
Methods: A total of 160 patients with ischemic cerebrovascular disease who took aspirin or clopidogrel for over one year were retrospectively analyzed, including 80 Mongolian and 80 han patients. The incidence, number, and distribution of CMBs were compared between groups.
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