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1.
Brain Behav Immun ; 88: 940-944, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32525049
2.
Clin Chim Acta ; 505: 43-48, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32088210

RESUMO

BACKGROUND: Intracerebral hemorrhage (ICH) can lead to inflammation. Serum amyloid A (SAA) is an acute phase protein, which might be implicated in acute brain injury. We ascertain relationship between serum SAA and inflammation, severity plus outcome after ICH. METHODS: In this prospective, observational study, serum SAA concentrations were quantified in 159 healthy volunteers and 159 acute primary basal ganglia hemorrhage patients admitted within 24 h after stroke symptom. Prognostic parameters included death and a poor outcome (modified Rankin Scale score > 2) at 90 days after stroke. RESULTS: Serum SAA concentrations were substantially higher in patients than in controls. Among patients, serum SAA concentrations were strongly correlated with serum C-reactive protein concentrations, hematoma volume and National Institutes of Health Stroke Scale scores. Serum SAA appeared to be an independent predictor for 90-day death, overall survival and poor outcome. Under receiver operating characteristic curve, this protein exhibited similar prognostic capability, as compared to hematoma volume and National Institutes of Health Stroke Scale scores. CONCLUSIONS: Rising serum SAA concentrations, in close correlation with inflammation and hemorrhagic severity, are independently related to mortality and poor outcome after ICH, indicating that serum SAA might serve as a potential prognostic biomarker for ICH.


Assuntos
Hemorragia dos Gânglios da Base/sangue , Proteína Amiloide A Sérica/análise , Idoso , Hemorragia dos Gânglios da Base/complicações , Biomarcadores/sangue , Proteína C-Reativa/análise , Feminino , Hematoma/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Curva ROC , Sensibilidade e Especificidade , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/etiologia , Análise de Sobrevida , Resultado do Tratamento
3.
World Neurosurg ; 134: 176-181, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31712110

RESUMO

BACKGROUND: Various radiologic patterns of posterior reversible encephalopathy syndrome (PRES) have been reported. Among them, PRES involving brainstem, thalamus, or deep white matter and lacking parieto-occipital edema is rare. Although PRES in general has a benign course, PRES-related intracranial hemorrhage has been associated with a poor prognosis. We report a case of variant type of PRES associated with deep brain hemorrhage and discuss the characteristics of PRES-related intracranial hemorrhage via a literature review. CASE DESCRIPTION: A woman aged 41 years with a history of untreated hypertension presented to our hospital complaining of severe headache and with an elevated blood pressure of 237/142 mmHg. Computed tomography revealed a hemorrhage in the left thalamus and basal ganglia. Magnetic resonance imaging revealed remarkable hyperintensity in the left cerebellum, pons, bilateral temporal lobes, bilateral basal ganglia, and bilateral cerebral white matter on fluid-attenuated inversion recovery imaging, which represented vasogenic edema. The parieto-occipital regions were unremarkable. Given this clinical presentation, PRES associated with deep brain hemorrhage was suspected. The patient received strict blood pressure control treatment, which resulted in gradual symptom improvement. Magnetic resonance images obtained 1 month after admission demonstrated an almost complete resolution of the edema. CONCLUSIONS: Although hemorrhage in the thalamus, basal ganglia, or brainstem is uncommon in patients with PRES, it may occur in patients with variant type of PRES involving these lesions. It is important to recognize the presence of variant patterns of clinical features and radiologic findings of PRES to allow for early identification and appropriate treatment.


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico por imagem , Síndrome da Leucoencefalopatia Posterior/diagnóstico por imagem , Doenças Talâmicas/diagnóstico por imagem , Adulto , Anti-Hipertensivos/uso terapêutico , Hemorragia dos Gânglios da Base/complicações , Hemorragia dos Gânglios da Base/fisiopatologia , Hemorragia Cerebral/complicações , Hemorragia Cerebral/diagnóstico por imagem , Hemorragia Cerebral/fisiopatologia , Feminino , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Imagem por Ressonância Magnética , Síndrome da Leucoencefalopatia Posterior/complicações , Síndrome da Leucoencefalopatia Posterior/fisiopatologia , Doenças Talâmicas/complicações , Doenças Talâmicas/fisiopatologia , Tomografia Computadorizada por Raios X
4.
J Craniofac Surg ; 30(8): e768-e771, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31348204

RESUMO

To evaluate the edema area around basal ganglia hemorrhage by the application of computerized tomography (CT)-based radiomics as a prognostic factor and improve the diagnosis efficacy, a total of 120 patients with basal ganglia hemorrhage were analyzed retrospectively. The texture analysis software Mazda 3.3 was used to preprocess the CT images and manually sketch the region of interest to extract the texture features. The extracted texture features were selected by Fisher coefficient, POE+ACC and mutual information. The texture discriminant analysis uses the B11 module in the Mazda 3.3 software. The data were randomly divided into a training dataset (67%) and test dataset (33%). To further study the texture features, the training dataset can be divided into groups according to the median of GCS score, NIHSS score, and maximum diameter of hematoma. Random forest model, support vector machine model, and neural network model were built. AUC of the receiver operating characteristics curve was used to assess the performance of models with test dataset. Among all texture post-processing methods, the lowest error rate was 2.22% for the POE+ACC/nonlinear discriminant. For the maximum diameter of hematoma, GCS score, and NIHSS score group, the lowest error rate were 26.66%, 23.33%, and 30.00%, respectively. The values of AUCs were 0.87, 0.81, and 0.76, for random forest model, support vector machine model, and neural network model in the test dataset, respectively. Radiomic method with proper model may have a potential role in predicting the edema area around basal ganglia hemorrhage. It can be used as a secondary group in the diagnosis of edema area around basal ganglia hemorrhage.


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico por imagem , Edema/diagnóstico por imagem , Idoso , Hemorragia dos Gânglios da Base/complicações , Edema/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
5.
World Neurosurg ; 127: 8-10, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30928593

RESUMO

BACKGROUND: Stereotactic ventro-oral thalamotomy has been performed in cases of focal task-specific dystonia, including writer's cramp, with excellent outcomes. However, no reports have revealed the outcome of ventro-oral thalamotomy in a patient with a contralateral cerebral lesion. We describe a patient with left-hand writer's cramp with an old lesion in the left hemisphere and transient gait disturbance after right ventro-oral thalamotomy. CASE DESCRIPTION: A 43-year-old man had a hemorrhage in the left basal ganglia due to cerebral arteriovenous malformation at 22 years of age, and right hemiparesis remained as a sequela. He developed left-handed writing ability; however, he became aware of the stiffness of his left hand and difficulty in writing. Writer's cramp was diagnosed. Medical treatments were not effective, and right ventro-oral thalamotomy was performed. Although his writing ability improved, he could not walk. After performing rehabilitation, his walking completely improved, reaching the level before surgery, after 3 months, and his writer's cramp was completely cured. CONCLUSIONS: In patients with basal nucleus lesions, gait disturbance may appear transiently after contralateral thalamotomy. It is crucial to fully explain the potential complications, particularly in relation to temporal gait disturbances, and obtain informed consent.


Assuntos
Distúrbios Distônicos/cirurgia , Transtornos Neurológicos da Marcha/etiologia , Procedimentos Neurocirúrgicos/efeitos adversos , Tálamo/cirurgia , Adulto , Hemorragia dos Gânglios da Base/complicações , Humanos , Masculino , Complicações Pós-Operatórias , Resultado do Tratamento
6.
J Clin Neurosci ; 64: 54-56, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30852075

RESUMO

We aimed to study the potential relationship of Guillain-Barré syndrome (GBS) and intracranial haemorrhage (ICH). We present a case of a 70-year-old hypertensive woman who developed global weakness, eventually becoming quadriplegic, during an inpatient stay for treatment of a basal ganglia haemorrhagic stroke. Guillain-Barré syndrome was confirmed and treatment initiated. She responded well to intravenous immunoglobulin treatment and then subsequently continued with rehabilitation. There have been a few case reports of GBS as a complication of spontaneous intracranial haemorrhage (ICH) or traumatic brain injury. It may not be a coincidence that our patient developed GBS shortly after presentation. There may be an immunological explanation with immune activation following neuronal injury after ICH with associated blood-brain barrier breakdown. GBS following ICH adds further complexity to treating patients who are already critically ill. If patients develop new weakness after ICH, there should be a high index of suspicion for GBS. It should be distinguished from critical illness neuropathy/myopathy and other causes of weakness in critical care patients because the treatment is very different. Immune activation and sensitization to myelin-associated proteins may be the underlying pathophysiological basis.


Assuntos
Hemorragia dos Gânglios da Base/complicações , Síndrome de Guillain-Barré/etiologia , Idoso , Feminino , Síndrome de Guillain-Barré/tratamento farmacológico , Síndrome de Guillain-Barré/fisiopatologia , Humanos , Imunoglobulinas Intravenosas/uso terapêutico
7.
World Neurosurg ; 125: 228-233, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30738934

RESUMO

BACKGROUND: Contralateral C7 nerve transfer is widely applied for the treatment of brachial plexus injuries or central paralysis of the upper extremities. The surgical approach has evolved from the precervical subcutaneous route to the prespinal route, which is currently the most commonly used one. We report a patient with central paralysis of the right upper extremity treated with contralateral C7 nerve transfer via the posterior spinal route. CASE DESCRIPTION: A 59-year-old female patient was admitted on 3 July, 2018 with right hemiplegia. The muscle strength of the right lower and upper extremities was grade 4 and 0, respectively. On the basis of magnetic resonance imaging, she was diagnosed with central paralysis of the right upper extremity. Considering the short length of the patient's healthy C7 nerve, contralateral C7 nerve transfer via the posterior spinal route was performed. No intraoperative complication was encountered. The patient reported slight numbness of the volar side of the left thumb, middle finger, and index finger after surgery. The patient showed a right shrug movement 1.5 months after surgery. CONCLUSION: We propose carrying out contralateral C7 nerve transfer via the posterior spinal route because of the shorter distance, no need for nerve transplantation, and low occurrence of the complications encountered with the prespinal route (such as vertebral artery injuries, esophageal fistula, and upper extremity pain when swallowing).


Assuntos
Hemiplegia/cirurgia , Transferência de Nervo/métodos , Raízes Nervosas Espinhais/cirurgia , Hemorragia dos Gânglios da Base/complicações , Neuropatias do Plexo Braquial/etiologia , Neuropatias do Plexo Braquial/cirurgia , Vértebras Cervicais , Feminino , Humanos , Pessoa de Meia-Idade , Extremidade Superior
9.
BMC Neurol ; 17(1): 180, 2017 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-28886692

RESUMO

BACKGROUND: Supernumerary phantom limb (SPL) is a rare neurologic phenomenon, in which a patient misperceives an extra limb in addition to the original set of limbs. We report a case of SPL in a patient with a right basal ganglia hemorrhage and review the previous literature about this peculiar phenomenon. CASE PRESENTATION: Two days after the event of a right basal ganglia hemorrhage, a 78-year-old male reported a phantom arm protruding from his left shoulder. He could not see or touch the phantom arm but he felt the presence of an addition arm lateral to his paretic arm. Pain or sensory discomfort were absent in either the paretic arm or the phantom arm. He stated that he could intentionally move the phantom arm independent of his paretic arm. The examination showed that the passive movement of his paretic arm did not elicit any movement of his phantom arm. We diagnosed the SPL as a complication of the hypertensive basal ganglia hemorrhage and treated him with anti-hypertensive medications. His phantom arm persisted for 3 weeks, and it gradually faded away. CONCLUSION: SPL had been reported as a rare complication of various types of cerebral lesions. Right hemispheric lesions were most frequently associated with the SPL. Considering the intentional movement of the phantom arm, we deduced that the SPL might result from the impairment of the sensory feedback system for both internal body image and motor movement.


Assuntos
Hemorragia dos Gânglios da Base/complicações , Gânglios da Base/fisiopatologia , Membro Fantasma , Idoso , Humanos , Masculino
11.
Eur Rev Med Pharmacol Sci ; 20(13): 2868-71, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27424987

RESUMO

OBJECTIVE: The aim of the present study is to investigate expressions of inflammatory cytokines and their relationship with cerebral edema in the patients with acute basal ganglia hemorrhage. PATIENTS AND METHODS: Between January 2015 and March 2016, 94 patients with acute basal ganglia hemorrhage admitted to our institution were included in the present study. Serum levels of interleukin (IL)-4, IL-6, IL-8 and IL-10 were measured using enzyme-linked immunosorbent assay (ELISA), and conditions of cerebral edema were evaluated using head CT upon admission, 1d after admission and 3d after admission, respectively. RESULTS: Serum levels of IL-4, IL-6 and IL-8 peaked 1d after admission and decreased 3d after admission with statistical significance (p <0.05); the IL-10 level was continuously increased after admission and peaked 3 days after admission with statistical significance (p<0.05). Cerebral edema was not observed in any of these patients upon admission, while occurred with a maximal edema volume 1 day after admission and the volume decreased 3 days after admission with statistical significance (p <0.05). Correlation analysis showed that levels of IL-4, IL-6 and IL-8 were positively correlated with severity of cerebral edema (r=0.324, 0286, 0.305, p <0.05 respectively), whereas IL-10 level was negatively correlated with severity of cerebral edema (r=-0.336, p <0.05). CONCLUSIONS: Serum levels of IL-4, IL-6 and IL-10 are positively correlated while the IL-10 level is negatively correlated with the severity of the cerebral edema in patients with acute basal ganglia hemorrhage.


Assuntos
Hemorragia dos Gânglios da Base/sangue , Edema Encefálico/sangue , Citocinas/sangue , Doença Aguda , Hemorragia dos Gânglios da Base/complicações , Edema Encefálico/etiologia , Humanos , Interleucina-10/sangue
14.
Neurocase ; 22(3): 300-5, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-26853846

RESUMO

Few studies have investigated language recovery patterns and the mechanisms of crossed bilingual aphasia following a subcortical stroke. In particular, Korean-Japanese crossed bilingual aphasia has not been reported. A 47-year-old, right-handed man was diagnosed with an extensive right basal ganglia hemorrhage. He was bilingual, fluent in both Korean and Japanese. After his stroke, the patient presented with crossed aphasia. We investigated changes in the Korean (L1) and Japanese (L2) language recovery patterns. Both Korean and Japanese versions of the Western Aphasia Battery (WAB) were completed one month after the stroke, and functional magnetic resonance imaging (fMRI) was performed using picture-naming tasks. The WAB showed a paradoxical pattern of bilingual aphasia, with an aphasia quotient (AQ) of 32 for Korean and 50.6 for Japanese, with Broca's aphasia. The patient scored better in the Japanese version of all domains of the tests. The fMRI study showed left lateralized activation in both language tasks, especially in the inferior frontal gyrus. After six months of language therapy targeting L1, the Korean-WAB score improved significantly, while the Japanese-WAB score showed slight improvement. In this case, the subcortical lesion contributed to crossed bilingual aphasia more highly affecting L1 due to loss of the cortico-subcortical control mechanism in the dominant hemisphere. The paradoxical pattern of bilingual aphasia disappeared after lengthy language therapy targeting L1, and the therapy effect did not transfer to L2. Language recovery in L1 might have been accomplished by reintegrating language networks, including the contralesional language homologue area in the left hemisphere.


Assuntos
Afasia de Broca/fisiopatologia , Hemorragia dos Gânglios da Base/complicações , Multilinguismo , Afasia de Broca/diagnóstico por imagem , Afasia de Broca/etiologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade
15.
Neurol Neurochir Pol ; 49(6): 456-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26652883

RESUMO

CONTEXT: Traumatic basal ganglia hemorrhage (TBGH) is a rare presentation of traumatic brain injury. Bilateral lesions are even rarer. Only twelve similar cases were previously published. CASE REPORT: We report the case of a patient with bilateral TBGH. He was managed conservatively. Long-term follow-up disclosed a cognitive dysfunctions attributed to associated diffuse axonal injury. Acceleration and deceleration forces may have torn pallidum arterial branches determining hemorrhage. CONCLUSION: Bilateral TBGH is an uncommon presentation of traumatic brain injury. Associated diffuse axonal injury worsens the outcome.


Assuntos
Hemorragia dos Gânglios da Base/patologia , Hemorragia Encefálica Traumática/patologia , Lesão Axonal Difusa/patologia , Hemorragia dos Gânglios da Base/complicações , Hemorragia Encefálica Traumática/complicações , Transtornos Cognitivos/etiologia , Lesão Axonal Difusa/complicações , Humanos , Masculino , Pessoa de Meia-Idade
16.
Ugeskr Laeger ; 177(51): V04150289, 2015 Dec 14.
Artigo em Dinamarquês | MEDLINE | ID: mdl-26692035

RESUMO

A 69-year-old woman with a medical history of stroke and an ICD device due to torsade de pointes was admitted with a right basal ganglia haemorrhage. In the hours after admission the patient's condition severely declined and she developed fever, hypertension and flushing consistent with autonomic dysfunction with sympathetic storming. ICD interrogation revealed electrical storm with 138 appropriate shocks delivered at the night of admission. We wish to draw attention to the close link between brain and heart, which in predisposed patients with a new stroke can cause malignant arrhythmias.


Assuntos
Doenças do Sistema Nervoso Autônomo/etiologia , Hemorragia dos Gânglios da Base/complicações , Taquicardia Sinusal/etiologia , Fibrilação Ventricular/etiologia , Idoso , Hemorragia dos Gânglios da Base/diagnóstico por imagem , Feminino , Humanos , Tomografia Computadorizada por Raios X
17.
Br J Neurosurg ; 28(4): 478-82, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24350736

RESUMO

This study investigated the clinical value of performing microsurgical treatment on hypertensive basal ganglia hemorrhage assisted by intraoperative ultrasound localization (IUL). A total of 107 patients with hypertensive basal ganglia hemorrhage were randomly separated into two groups for this controlled clinical trial. In the IUL group, 51 patients with hypertensive basal ganglia hemorrhage were operated on with the support of ultrasonic imaging; 56 patients underwent conventional microsurgery to evacuate the hemorrhage. The results of the two methods were evaluated according to the rate of hematoma evacuation, re-hemorrhage, mortality, complications, and activities of daily living (ADL). A greater quantity of the hemorrhage was removed from patients in the IUL group, with over 90% of masses being eliminated from the brain in 78.43% of these patients (40 out of 51 patients) compared with 60.71% of patients in the control group (34 out of 56 patients). The IUL group experienced a lower rate of re-hemorrhage after the operation (7.84%, 4 out of 51 patients) compared with the control group (17.86%, 10 out of 56 patients). A significant difference in the ADL score was recorded between the two groups, with ADL scores of the IUL group exceeding 60 (indicating good recovery) at 6 months after the operative procedure (P < 0.05). In conclusion, the microsurgical treatment of hypertensive basal ganglia hemorrhage assisted by IUL improved the precision of the operation. This procedure removed the hemorrhage and reduced the changes of re-occurrence, as well as elevated the quality of life of patients after the operation.


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico por imagem , Hemorragia dos Gânglios da Base/cirurgia , Hipertensão , Microcirurgia , Procedimentos Neurocirúrgicos , Adulto , Idoso , Idoso de 80 Anos ou mais , Hemorragia dos Gânglios da Base/complicações , Feminino , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/métodos , Complicações Pós-Operatórias/prevenção & controle , Qualidade de Vida , Resultado do Tratamento , Ultrassonografia
18.
J Neurol Sci ; 322(1-2): 77-8, 2012 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-22795553

RESUMO

Traumatic brain injury (TBI) can result in cognitive and behavioral impairments such as poor attention, learning, memory and planning ability and uncontrolled crying that can be more persistent problems than the physical disabilities. Cognitive enhancers have been shown to improve cognitive and behavioral impairments in patients with hemorrhagic basal ganglia lesions as well as other forms of TBI. There is little research about the use of cognitive enhancers after hemorrhagic basal ganglia damage. We present a case of a 38 year old male who made significant recovery with the use of cognitive enhancers.


Assuntos
Hemorragia dos Gânglios da Base/complicações , Hemorragia dos Gânglios da Base/tratamento farmacológico , Transtornos Cognitivos/etiologia , Galantamina/uso terapêutico , Metilfenidato/uso terapêutico , Nootrópicos/uso terapêutico , Adulto , Transtornos Cognitivos/tratamento farmacológico , Escala de Coma de Glasgow , Humanos , Masculino , Transtornos Mentais , Testes Neuropsicológicos , Tomógrafos Computadorizados
19.
Neurocrit Care ; 17(2): 172-6, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22833445

RESUMO

INTRODUCTION: The characteristics and sequelae of intracranial hypertension after ICH are unclear. METHODS: In a cohort of patients with spontaneous ICH, we obtained ICP values from nursing documentation of hourly vital signs and reviewed charts to rule out spurious ICP recordings. We used multiple logistic regression to explore factors associated with intracranial hypertension, and ordinal logistic regression controlling for the ICH score to examine the relationship between intracranial hypertension and the mRS score at 12 months. RESULTS: Among 243 patients, 57 (24 %) underwent ICP monitoring, of whom 40 (70 %; 95 % CI 57-82 %) had an episode of ICP > 20 mmHg. Intracranial hypertension was less likely in older patients (OR per decade 0.6, 95 % CI 0.3-0.9) and after infratentorial hemorrhage (OR 0.1, 95 % CI 0-0.7). Intracranial hypertension was not independently associated with mRS scores (OR 0.8, 95 % CI 0.3-2.3); this remained true for a threshold of >25 mmHg (OR 0.5, 95 % CI 0.2-1.5), number of elevations (OR 0.98 per elevation, 95 % CI 0.96-1.00), or area under the curve (OR 1.00 per mmHg × h, 95 % CI 0.99-1.01). Among patients with intracranial hypertension, seven (18 %) were functionally independent (mRS 0-2) at 12 months. Our results were not significantly changed after excluding patients with early DNR orders. CONCLUSION: Intracranial hypertension is common after ICH, especially in younger patients with supratentorial hemorrhage. Given active treatment of elevated ICP, intracranial hypertension does not appear associated with long-term outcomes, suggesting that ICP elevations should not necessarily be taken to signify a poor prognosis.


Assuntos
Hemorragia Cerebral/fisiopatologia , Hipertensão Intracraniana/fisiopatologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Hemorragia dos Gânglios da Base/complicações , Hemorragia dos Gânglios da Base/fisiopatologia , Doenças Cerebelares/complicações , Doenças Cerebelares/fisiopatologia , Hemorragia Cerebral/complicações , Hemorragia Cerebral/patologia , Estudos de Coortes , Feminino , Humanos , Hipertensão Intracraniana/complicações , Pressão Intracraniana , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Doenças Talâmicas/complicações , Doenças Talâmicas/fisiopatologia
20.
BMC Neurol ; 12: 34, 2012 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-22676908

RESUMO

BACKGROUND: Spontaneous intracerebral hemorrhage is a disease with high morbidity, high disability rate, high mortality, and high economic burden. Whether patients can benefit from surgical evacuation of hematomas is still controversial, especially for those with moderate-volume hematomas in the basal ganglia. This study is designed to compare the efficacy of endoscopic surgery and conservative treatment for the moderate-volume hematoma in spontaneous basal ganglia hemorrhage. METHODS: Patients meet the criteria will be randomized into the endoscopic surgery group (endoscopic surgery for hematoma evacuation and the best medical treatment) or the conservative treatment group (the best medical treatment). Patients will be followed up at 1, 3, and 6 months after initial treatment. The primary outcomes include the Extended Glasgow Outcome Scale and the Modified Rankin Scale. The secondary outcomes consist of the National Institutes of Health Stroke Scale and the mortality. The Barthel Index(BI) will also be evaluated. The sample size is 100 patients. DISCUSSION: The ECMOH trial is a randomized controlled trial designed to evaluate if endoscopic surgery is better than conservative treatment for patients with moderate-volume hematomas in the basal ganglia. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR-TRC-11001614(http://www.chictr.org/en/proj/show.aspx?proj=1618).


Assuntos
Hemorragia dos Gânglios da Base/diagnóstico , Hemorragia dos Gânglios da Base/terapia , Hematoma Epidural Craniano/diagnóstico , Hematoma Epidural Craniano/terapia , Adolescente , Adulto , Idoso , Hemorragia dos Gânglios da Base/complicações , Endoscopia , Feminino , Hematoma Epidural Craniano/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
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