[Intracerebral haemorrhage, what's new?].
Haemorrhagic stroke is frequent and associated with a high mortality and morbidity. Less than 30% of patients are still alive five years after onset and few patients regain functional independence. The worsening effect of anticoagulation has been demonstrated and the failure to rapidly normalize coagulation further increases haematoma expansion. In a recent phase II trial, recombinant activated factor VII given within 4 hours of stroke onset, reduced haematoma growth, mortality and disability. An aggressive blood pressure and intracranial pressure control early after the haemorrhage seems beneficial. A large prospective randomized study (the STICH trial) did not demonstrate any beneficial effect of surgery.
Grillo
P
P
Département d'Anesthésie-Réanimation, CHU de La Timone-Adultes, 264, rue Saint-Pierre, 13385 Marseille, France.
Velly
L
L
Bruder
N
N
D000818:Animals; D002543:Cerebral Hemorrhage / Q000150:complications / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D002986:Clinical Trials as Topic; D005167:Factor VII / Q000627:therapeutic use; D006487:Hemostasis; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D011994:Recombinant Proteins / Q000627:therapeutic use; D020521:Stroke / Q000209:etiology / Q000401:mortality / Q000601:surgery / Q000628:therapy*
D011994:Recombinant Proteins; D005167:Factor VII