Prevention of intracerebral haemorrhage.
Nontraumatic intracerebral haemorrhages arise from a wide range of causes falling into two broad groups: discreet vascular "ictohaemorrhagic" lesions such as aneurysms, arteriovenous malformations, cavernomas, tumours, and dural fistulae; and more generalised amyloid or hypertension related conditions. It is now possible using family history, associated risk factors and gradient echo MRI to predict cases at high risk of hypertensive or amyloid related haemorrhage. There is considerable potential for prevention of hypertensive haemorrhages by treatment of high risk cases with antihypertensive medication. As yet no effective preventative treatment for amyloid angiopathy related ICH has emerged although a variety of drugs are under investigation. Prevention of haemorrhage from ictohaemorrhagic lesions revolves around removal or obliteration of the lesion. Although there is a wide range of such lesions available treatments come down to three modalities. These are surgical excision, stereotactic radiosurgery and endovascular embolisation.
Mitchell
Patrick
P
Department of Neurosurgery, Newcastle General Hospital, Newcastle upon Tyne, UK. patrick.mitchell@newcastle.ac.uk
Mitra
Dipayan
D
Gregson
Barbara A
BA
Mendelow
A David
AD
D000925:Anticoagulants / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D020785:Central Nervous System Vascular Malformations / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control*; D004621:Embolization, Therapeutic; D005343:Fibrinolytic Agents / Q000009:adverse effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000628:therapy; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D008279:Magnetic Resonance Imaging; D019636:Neurodegenerative Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D010375:Pedigree; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D016634:Radiosurgery; D018570:Risk Assessment; D012307:Risk Factors; D014656:Vascular Surgical Procedures / Q000009:adverse effects
D000925:Anticoagulants; D000959:Antihypertensive Agents; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors