Intensive care management of acute stroke: surgical treatment.
Controversy still exists on surgical management of acute stroke. Even if surgical therapy represents often a life-saving measure, the issue of acceptable outcome remains open. Persuasive evidence for outcome benefit is limited. For large ischaemic strokes, recent convincing data suggest that decompressive surgery significantly reduces mortality and improves outcome quality. On the other hand, despite the long tradition in surgical removal of intracranial haematomas, the recent evidence has not been sufficient to resolve the basic argument whether to operate or not. Most recently, hopeful preliminary data have emerged on new approaches in the treatment of intraventricular haemorrhage. In this article, we review the current neurosurgical options in acute ischaemic and haemorrhagic stroke.
Department of Neurology, University of Heidelberg, Heidelberg, Germany. marek.sykora@med.uni-heidelberg.de
Marek
M
Sykora
Jennifer
J
Diedler
Eric
E
Jüttler
Thorsten
T
Steiner
Klaus
K
Zweckberger
Werner
W
Hacke
Andreas
A
Unterberg
D000208:Acute Disease; D002545:Brain Ischemia / Q000601:surgery; D002526:Cerebellar Diseases / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000150:complications / Q000601:surgery; D002544:Cerebral Infarction / Q000601:surgery; D003422:Critical Care; D019299:Decompression, Surgical; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000601:surgery; D020521:Stroke / Q000601:surgery* / Q000628:therapy*