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+ | ====== Hemorragia cerebral espontánea ====== | ||
+ | ===== Definición ===== | ||
+ | La [[hemorragia cerebral]] espontánea es una colección hemática dentro del [[parénquima cerebral|]] en ausencia de [[traumatismo]] o [[intervención quirúrgica]] previa. | ||
+ | |||
+ | ===== Epidemiología ===== | ||
+ | |||
+ | Representa el 10-15% de todos los [[ictus]], y según su localización puede ser intra[[parenquima]]tosa o [[intraventricular]]. | ||
+ | |||
+ | Es la 3ª causa de muerte y se estima la duplicación de su [[incidencia]] en el año 2050. | ||
+ | |||
+ | Se presenta con doble de frecuencia que la [[hemorragia subaracnoidea|hemorragia subaracnoidea]] y tiene peor pronóstico que esta. | ||
+ | |||
+ | A partir de los 55 años de edad, la frecuencia es doble por cada década que pasa. | ||
+ | |||
+ | Se produce con mayor frecuencia en personas de raza negra y japoneses. | ||
+ | |||
+ | En cuanto al sexo, no se observan diferencias significativas entre ellos. | ||
+ | |||
+ | Más frecuente por la mañana y en invierno. | ||
+ | ===== Clasificación ===== | ||
+ | |||
+ | ver [[Clasificación de la hemorragia cerebral espontánea]]. | ||
+ | |||
+ | ===== Etiología ===== | ||
+ | |||
+ | ver [[Etiología de la hemorragia cerebral espontánea]]. | ||
+ | |||
+ | |||
+ | ===== Clínica ===== | ||
+ | |||
+ | La clínica va a depender de la localización , del tamaño, | ||
+ | |||
+ | Característicamente se produce un intenso dolor de cabeza, vómitos y alteración en el nivel de conciencia. | ||
+ | |||
+ | Puede presentarse como una parálisis de la mitad del cuerpo, disminución de la apertura y desviación de los ojos hacia el lado del cerebro donde se produjo la hemorragia y dificultad para hablar. También puede manifestarse con una alteración para mover los ojos y disminución en la sensibilidad. | ||
+ | |||
+ | Uno de cada 4 pacientes va a presentar un deterioro clínico en las próximas 24 horas sobre todo en alcoholismo, | ||
+ | |||
+ | ===== Diagnóstico ===== | ||
+ | |||
+ | ver [[Diagnóstico de la hemorragia cerebral]]. | ||
+ | |||
+ | |||
+ | |||
+ | |||
+ | ===== Tratamiento ===== | ||
+ | |||
+ | [[Tratamiento de la hemorragia intracerebral espontánea]]. | ||
+ | |||
+ | |||
+ | ====Pronóstico==== | ||
+ | |||
+ | La fiebre y el crecimiento del hematoma son predictores independientes de mal pronóstico. | ||
+ | |||
+ | Se necesitan investigaciones futuras para estudiar los mecanismos de este fenómeno y analizar si los protocolos iniciales de modulación de la temperatura se asocia con mejores resultados (Rincon y col., 2012). | ||
+ | |||
+ | Solo un 20 % podrán realizar una vida independiente 6 meses después. | ||
+ | |||
+ | El 50 % fallecen en el primer mes. | ||
+ | |||
+ | Los volúmenes de >60 cm3 tienen una mortalidad del 90 % | ||
+ | |||
+ | ===Escalas pronósticas=== | ||
+ | |||
+ | El pronóstico final de los pacientes, no depende de una variable aislada, sino de la conjunción de varias; por ello se han intentado crear escalas pronósticas que las agrupen. | ||
+ | |||
+ | En la actualidad han surgido escalas breves, simples y con alta sensibilidad como la “ICH score” creada por Hemphill. | ||
+ | |||
+ | Enlace http:// | ||
+ | |||
+ | ====Conclusiones==== | ||
+ | |||
+ | No esta clara la estrategia a seguir. | ||
+ | |||
+ | Estudios mal diseñados. | ||
+ | |||
+ | Deben de agruparse en Localización, | ||
+ | |||
+ | No agrupar sistemáticamente todos los tipos de intervención quirúrgica. | ||
+ | |||
+ | Hasta el momento, ninguna intervención en particular es claramente superior. | ||
+ | |||
+ | Una revisión de los estudios aleatorios disponibles, | ||
+ | |||
+ | Esto puede ser en particular verdadero en pacientes jóvenes con signos de deterioro neurológico reciente. | ||
+ | |||
+ | Reducir el volumen de hematoma permanece como pilar básico. | ||
+ | |||
+ | Las futuras investigaciones e intervenciones van indudablemente en esta dirección. | ||
+ | |||
+ | Este interés en identificar mecanismos bioquímicos refleja el aumento reciente de publicaciones de investigación de mecanismos celulares y moleculares | ||
+ | |||
+ | Mientras tanto, la responsabilidad permanece sobre el clínico para hacer el juicio terapéutico lo mejor posible. | ||
+ | |||
+ | ====Bibliografía==== | ||
+ | Rincon, Fred, Patrick Lyden, and Stephan A Mayer. 2012. “Relationship Between Temperature, | ||
+ | |||
+ | |||
+ | |||
+ | ====Bibliografía recomendada==== | ||
+ | |||
+ | 1. Abilleira S, Montaner J, Molina CA, et al: Matrix metalloproteinase concentration after spontaneous intracerebral hemorrhage. J Neurosurg 99:65–70, 2003 | ||
+ | |||
+ | 2. Adams RE, Diringer MN: Response to external ventricular drainage in spontaneous intracerebral hemorrhage with hydrocephalus. Neurology 50: | ||
+ | |||
+ | 3. Adams RE, Powers WJ: Management of hypertension in acute intracerebral hemorrhage. Crit Care Clin 13: | ||
+ | |||
+ | 4. Al-Jarallah A, Al-Rifai MT, Riela AR, et al: Nontraumatic brain hemorrhage in children: etiology and presentation. J Child | ||
+ | Neurol 15: | ||
+ | |||
+ | 5. Astrup J, Siesjo BK, Symon L: Thresholds in cerebral ischemia the ischemic penumbra. Stroke 12: | ||
+ | |||
+ | 6. Auer LM, Deinsberger W, Niederkorn K, et al: Endoscopic surgery | ||
+ | versus medical treatment for spontaneous intracerebral hematoma: | ||
+ | a randomized study. J Neurosurg 70: | ||
+ | |||
+ | 7. Backlund EO, von Holst H: Controlled subtotal evacuation of | ||
+ | intracerebral haematomas by stereotactic technique. Surg Neurol | ||
+ | 9:99–101, 1978 | ||
+ | |||
+ | 8. Barinagarrementeria F, Mendez A, Vega F: [Cerebral hemorrhage | ||
+ | associated with the use of phenylpropanolamine.] Neurologia | ||
+ | 5: | ||
+ | |||
+ | 9. Batjer HH, Reisch JS, Allen BC, et al: Failure of surgery to improve | ||
+ | outcome in hypertensive putaminal hemorrhage. A prospective | ||
+ | randomized trial. Arch Neurol 47: | ||
+ | 10. Bladin CF, Alexandrov AV, Bellavance A, et al: Seizures after | ||
+ | stroke: a prospective multicenter study. Arch Neurol 57: | ||
+ | 1617–1622, | ||
+ | 11. Broderick J, Brott T, Kothari R, et al: Very early edema growth | ||
+ | not significantly associated with neurologic deterioration in | ||
+ | patients with intracerebral hemorrhage. Stroke 26:184, 1995 | ||
+ | (Abstract) | ||
+ | 12. Broderick JP: Intracerebral hemorrhage, in Gorelick PB, Alter | ||
+ | M (eds): Handbook of Neuroepidemiology. New York: Marcel | ||
+ | Dekker, 1994, pp 141–167 | ||
+ | 13. Broderick JP, Adams HP Jr, Barsan W, et al: Guidelines for the | ||
+ | management of spontaneous intracerebral hemorrhage: a statement | ||
+ | for healthcare professionals from a special writing group | ||
+ | of the Stroke Council, American Heart Association. Stroke 30: | ||
+ | 905–915, 1999 | ||
+ | 14. Broderick JP, Brott T: Predictions of outcomes after intracerebral | ||
+ | hemorrhage. Stroke 24:1761, 1993 | ||
+ | 15. Broderick JP, Brott T, Tomsick T, et al: Intracerebral hemor- | ||
+ | rhage more than twice as common as subarachnoid hemorrhage. | ||
+ | J Neurosurg 78: | ||
+ | 16. Broderick JP, Brott T, Tomsick T, et al: The risk of subarachnoid | ||
+ | and intracerebral hemorrhages in blacks as compared with | ||
+ | whites. N Engl J Med 326: | ||
+ | 17. Broderick JP, Brott T, Zuccarello M: Management of intracerebral | ||
+ | hemorrhage, in Batjer HH (ed): Cerebrovascular Disease. | ||
+ | Philadelphia: | ||
+ | 18. Broderick JP, Brott TG, Duldner JE, et al: Volume of intracerebral | ||
+ | hemorrhage. A powerful and easy-to-use predictor of 30- | ||
+ | day mortality. Stroke 24: | ||
+ | 19. Brott T, Broderick J, Kothari R, et al: Early hemorrhage growth | ||
+ | in patients with intracerebral hemorrhage. Stroke 28:1–5, 1997 | ||
+ | 20. Brott T, Thalinger K, Hertzberg V: Hypertension as a risk | ||
+ | factor for spontaneous intracerebral hemorrhage. Stroke 17: | ||
+ | 1078–1083, | ||
+ | 21. Cantu C, Arauz A, Murillo-Bonilla LM, et al: Stroke associated | ||
+ | with sympathomimetics contained in over-the-counter cough | ||
+ | and cold drugs. Stroke 34: | ||
+ | 22. Caplan LR: General symptoms and signs, in Kase CS, Caplan | ||
+ | LR (eds): Intracerebral Hemorrhage. Boston: Butterworth- | ||
+ | Heinemann, pp 31–43, 1994 | ||
+ | 23. Cervoni L, Artico M, Salvati M, et al: Epileptic seizures in intracerebral | ||
+ | hemorrhage: a clinical and prognostic study of 55 | ||
+ | cases. Neurosurg Rev 17: | ||
+ | 24. Challa VR, Moody DM, Bell MA: The Charcot-Bouchard aneurysm | ||
+ | controversy: | ||
+ | Neuropathol Exp Neurol 51: | ||
+ | 25. Chaney RK, Taber KH, Orrison WW Jr, et al: Magnetic resonance | ||
+ | imaging of intracerebral hemorrhage at different field | ||
+ | strengths. Neuroimaging Clin N Am 2:25–51, 1992 | ||
+ | 26. Charcot JM, Bouchard C: 642 Nouvelles recerches sur la pathogenie | ||
+ | de l’hemorrhagie cerebrale. Arch Physiol Norm Pathol: | ||
+ | 110–127, 1868 | ||
+ | 27. Chen X, Yang H, Czherig Z: A prospective randomized trial of | ||
+ | surgical and conservative treatment of hypertensive intracranial | ||
+ | haemorrhage. Acta Acad Med Shanghai 19: | ||
+ | 28. Cohen WA, Hayman LA: Computed tomography of intracranial | ||
+ | hemorrhage. Neuroimaging Clin N Am 2:75–87, 1992 | ||
+ | 29. Cushing H: Some experimental and clinical observations concerning | ||
+ | states of increased intracranial tension. Am J Med Sci | ||
+ | 124: | ||
+ | 30. Dandapani BK, Suzuki S, Kelley RE, et al: Relation between | ||
+ | blood pressure and outcome in intracerebral hemorrhage. | ||
+ | Stroke 26:21–24, 1995 | ||
+ | 31. Dennis MS, Burn JP, Sandercock PA, et al: Long-term survival | ||
+ | after first-ever stroke: the Oxfordshire Community Stroke Project. | ||
+ | Stroke 24: | ||
+ | 32. Doi E, Moriwaki H, Komai N, et al: [Stereotactic evacuation | ||
+ | of intracerebral hematomas.] Neurol Med Chir 22: | ||
+ | 1982 (Jpn) | ||
+ | 33. Felber S, Auer A, Wolf C, et al: [MRI characteristics of spontaneous | ||
+ | intracerebral hemorrhage.] Radiologe 39: | ||
+ | (Ger) | ||
+ | 34. Fernandes HM, Gregson B, Siddique MS, et al: Surgery in intracerebral | ||
+ | hemorrhage. The uncertainty continues. Stroke 31: | ||
+ | 2511–2516, | ||
+ | 35. Fernandes HM, Mendelow AD: Spontaneous intracerebral | ||
+ | haemorrhage: | ||
+ | 389–394, 1999 | ||
+ | 36. Findlay JM, Grace MG, Weir BK: Treatment of intraventricular | ||
+ | hemorrhage with tissue plasminogen activator. Neurosurgery | ||
+ | 32: | ||
+ | 37. Fisher CM: Pathological observations in hypertensive cerebral | ||
+ | hemorrhage. J Neuropathol Exp Neurol 30: | ||
+ | 38. Fogelholm R, Eskola K, Kiminkinen T, et al: Anticoagulant | ||
+ | treatment as a risk factor for primary intracerebral haemorrhage. | ||
+ | J Neurol Neurosurg Psychiatry 55: | ||
+ | 39. Fujii Y, Takeuchi S, Sasaki O, et al: Multivariate analysis of | ||
+ | predictors of hematoma enlargement in spontaneous intracerebral | ||
+ | hemorrhage. Stroke 29: | ||
+ | 40. Gallerani M, Trappella G, Manfredini R, et al: Acute intracerebral | ||
+ | haemorrhage: | ||
+ | Acta Neurol Scand 89: | ||
+ | 41. Guridi J, Gallego J, Mornzon F, et al: Intracerebral hemorrhage | ||
+ | caused by transmural dissection of the anterior cerebral artery. | ||
+ | Stroke 24: | ||
+ | 42. Garner TB, Curling OD Jr, Kelly DL Jr, et al: The natural history | ||
+ | of intracranial venous angiomas. J Neurosurg 75: | ||
+ | 715–722, 1991 | ||
+ | 43. Griffiths PD, Beveridge CJ, Gholkar A: Angiography in nontraumatic | ||
+ | brain haematoma. Acta Radiol 38: | ||
+ | 44. Hacke W, Brott T, Caplan L, et al: Thrombolysis in acute ischemic | ||
+ | stroke: controlled trials and clinical experience. Neurology | ||
+ | 53 (7 Suppl 4): | ||
+ | 45. Halpin SF, Britton JA, Byrne JV, et al: Prospective evaluation | ||
+ | of cerebral angiography and computed tomography in cerebral | ||
+ | haematoma. J Neurol Neurosurg Psychiatry 57: | ||
+ | 1994 | ||
+ | 46. Hankey GJ, Hon C: Surgery for primary intracerebral hemorrhage: | ||
+ | is it safe and effective? A systematic review of case | ||
+ | series and randomized trials. Stroke 28: | ||
+ | 47. Hart RG, Boop BS, Anderson DC: Oral anticoagulants and | ||
+ | intracranial hemorrhage. Facts and hypotheses. Stroke 26: | ||
+ | 1471–1477, | ||
+ | 48. He J, Whelton PK, Vu B, et al: Aspirin and risk of hemorrhagic | ||
+ | stroke: a meta-analysis of randomized controlled trials. JAMA | ||
+ | 280: | ||
+ | 49. Hickenbottom SL, Grotta JC, Strong R, et al: Nuclear factorkappaB | ||
+ | and cell death after experimental intracerebral hemorrhage | ||
+ | in rats. Stroke 30: | ||
+ | 50. Hinton DR, Dolan E, Sima AA: The value of histopathological | ||
+ | examination of surgically removed blood clot in determining | ||
+ | the etiology of spontaneous intracerebral hemorrhage. Stroke | ||
+ | 15: | ||
+ | 51. Hirano T, Read SJ, Abbott DF, et al: No evidence of hypoxic | ||
+ | tissue on 18F-fluoromisonidazole PET after intracerebral hemorrhage. | ||
+ | Neurology 53: | ||
+ | 52. Hua Y, Xi G, Keep RF, et al: Complement activation in the | ||
+ | brain after experimental intracerebral hemorrhage. J Neurosurg | ||
+ | 92: | ||
+ | 53. Huang FP, Xi G, Keep RF, et al: Brain edema after experimental | ||
+ | intracerebral hemorrhage: role of hemoglobin degradation | ||
+ | products. J Neurosurg 96: | ||
+ | 54. Iso H, Jacobs DR Jr, Wentworth D, et al: Serum cholesterol levels | ||
+ | and six-year mortality from stroke in 350, 977 men screened | ||
+ | for the multiple risk factor intervention trial. N Engl J Med | ||
+ | 320: | ||
+ | 55. Italian Acute Stroke Study Group: Haemodilution in acute | ||
+ | stroke: results of the Italian haemodilution trial. Lancet 1: | ||
+ | 318–321, 1988 | ||
+ | 56. Iwama T, Ohkuma A, Miwa Y, et al: Brain tumors manifesting | ||
+ | as intracranial hemorrhage. Neurol Med Chir 32: | ||
+ | 1992 | ||
+ | 57. Izumihara A, Ishihara T, Iwamoto N, et al: Postoperative outcome | ||
+ | of 37 patients with lobar intracerebral hemorrhage related | ||
+ | to cerebral amyloid angiopathy. Stroke 30:29–33, 1999 | ||
+ | 58. Johnsen SP, Pedersen L, Friis S, et al: Nonaspirin nonsteroidal | ||
+ | anti-inflammatory drugs and risk of hospitalization for intracerebral | ||
+ | hemorrhage: a population-based case-control study. | ||
+ | Stroke 34: | ||
+ | 59. Juvela S: Prevalence of risk factors in spontaneous intracerebral | ||
+ | hemorrhage and aneurysmal subarachnoid hemorrhage. Arch | ||
+ | Neurol 53: | ||
+ | 60. Juvela S: Risk factors for impaired outcome after spontaneous | ||
+ | intracerebral hemorrhage. Arch Neurol 52: | ||
+ | 61. Juvela S, Heiskanen O, Poranen A, et al: The treatment of spontaneous | ||
+ | intracerebral hemorrhage. A prospective randomized | ||
+ | M. E. Fewel, B. G. Thompson, Jr., and J. T. Hoff | ||
+ | 14 Neurosurg. Focus / Volume 15 / October, 2003 | ||
+ | trial of surgical and conservative treatment. J Neurosurg 70: | ||
+ | 755–758, 1989 | ||
+ | 62. Juvela S, Hillbom M, Palomaki H: Risk factors for spontaneous | ||
+ | intracerebral hemorrhage. Stroke 26: | ||
+ | 63. Kanaya H, Kuroda K: Development in neurosurgical approaches | ||
+ | to hypertensive intracerebral hemorrhage in Japan, in Kaufman | ||
+ | HH (ed): Intracerebral Hematomas. New York: Raven | ||
+ | Press, 1992, pp 197–210 | ||
+ | 64. Kaneko M, Tanaka K, Shimada T, et al: Long-term evaluation | ||
+ | of ultra-early operation for hypertensive intracerebral hemorrhage | ||
+ | in 100 cases. J Neurosurg 58: | ||
+ | 65. Kaneko T, Sawada T, Niimi T, et al: Lower limit of blood pressure | ||
+ | treatment of acute hypertensive intracranial hemorrhage. J | ||
+ | Cereb Blood Flow Metab 3 (Suppl 1): | ||
+ | 66. Karibe H, Niizuma H, Ohyama H, et al: Hepatitis C virus | ||
+ | (HCV) infection as a risk factor for spontaneous intracerebral | ||
+ | hemorrhage: hospital based case-control study. J Clin Neurosci | ||
+ | 8: | ||
+ | 67. Kazui S, Minematsu K, Yamamoto H, et al: Predisposing factors | ||
+ | to enlargement of spontaneous intracerebral hematoma. | ||
+ | Stroke 28: | ||
+ | 68. Kazui S, Naritomi H, Yamamoto H, et al: Enlargement of spontaneous | ||
+ | intracerebral hemorrhage. Incidence and time course. | ||
+ | Stroke 27: | ||
+ | 69. Kirkpatrick JB, Hayman LA: Pathophysiology of intracranial | ||
+ | hemorrhage. Neuroimaging Clin N Am 2:11–23, 1992 | ||
+ | 70. Kirollos RW, Tyagi AK, Ross SA, et al: Management of spontaneous | ||
+ | cerebellar hematomas: a prospective treatment protocol. | ||
+ | Neurosurgery 49: | ||
+ | 71. Kothari RU, Brott T, Broderick JP, et al: The ABCs of measuring | ||
+ | intracerebral hemorrhage volumes. Stroke 27: | ||
+ | 1996 | ||
+ | 72. Kuwata N, Kuroda K, Funayama M, et al: Dysautoregulation in | ||
+ | patients with hypertensive intracerebral hemorrhage. A SPECT | ||
+ | study. Neurosurg Rev 18: | ||
+ | 73. Lee KR, Betz AL, Keep RF, et al: Intracerebral infusion of | ||
+ | thrombin as a cause of brain edema. J Neurosurg 83: | ||
+ | 1045–1050, | ||
+ | 74. Lee KR, Kawai N, Kim S, et al: Mechanisms of edema formation | ||
+ | after intracerebral hemorrhage: effects of thrombin on cerebral | ||
+ | blood flow, blood-brain barrier permeability, | ||
+ | in a rat model. J Neurosurg 86: | ||
+ | 75. Linfante I, Llinas RH, Caplan LR, et al: MRI features of intracerebral | ||
+ | hemorrhage within 2 hours from symptom onset. | ||
+ | Stroke 30: | ||
+ | 76. Malik GM, Morgan JK, Boulos RS, et al: Venous angiomas: an | ||
+ | underestimated cause of intracranial hemorrhage. Surg Neurol | ||
+ | 30: | ||
+ | 77. Matsumoto K, Hondo H: CT-guided stereotaxic evacuation | ||
+ | of hypertensive intracerebral hematomas. J Neurosurg 61: | ||
+ | 440–448, 1984 | ||
+ | 78. Matthews MK Jr: Association of Ginkgo biloba with intracerebral | ||
+ | hemorrhage. Neurology 50: | ||
+ | 79. Mayer SA: Ultra-early hemostatic therapy for intracerebral hemorrhage. | ||
+ | Stroke 34: | ||
+ | 80. Mayer SA, Lignelli A, Fink ME, et al: Perilesional blood flow | ||
+ | and edema formation in acute intracerebral hemorrhage. A | ||
+ | SPECT study. Stroke 29: | ||
+ | 81. Mayer SA, Sacco RL, Shi T, et al: Neurologic deterioration in | ||
+ | noncomatose patients with supratentorial intracerebral hemorrhage. | ||
+ | Neurology 44: | ||
+ | 82. Maymon R, Fejgin M: Intracranial hemorrhage during pregnancy | ||
+ | and puerperium. Obstet Gynecol Surv 45: | ||
+ | 83. McEvoy AW, Kitchen ND, Thomas DG: Intracerebral haemorrhage | ||
+ | caused by drug abuse. Lancet 351:1029, 1998 | ||
+ | 84. McKissock W, Richardson A, Taylor J: Primary intracerebral | ||
+ | hemorrhage. A controlled trial of surgical and conservative | ||
+ | treatment in 180 unselected cases. Lancet 2: | ||
+ | 85. Mendelow AD: Surgical trial in intracerebral haemorrhage | ||
+ | (S.T.I.C.H.). Acta Neurochir Suppl 76: | ||
+ | 86. Meyer JS, Bauer RB: Medical treatment of spontaneous intracranial | ||
+ | hemorrhage by the use of hypotensive drugs. Neurology | ||
+ | 12:36–47, 1962 | ||
+ | 87. Mohadjer M, Braus DF, Myers A, et al: CT-stereotactic fibrinolysis | ||
+ | of spontaneous intracerebral hematomas. Neurosurg | ||
+ | Rev 15: | ||
+ | 88. Montes J, Wong JH, Fayad PB, et al: Stereotactic computed | ||
+ | tomographic-guided aspiration and thrombolysis of intracerebral | ||
+ | hematoma: protocol and preliminary experience. Stroke | ||
+ | 31: | ||
+ | 89. Morgenstern LB, Demchuk AM, Kim DH, et al: Rebleeding | ||
+ | leads to poor outcome in ultra-early craniotomy for intracerebral | ||
+ | hemorrhage. Neurology 56: | ||
+ | 90. Morgenstern LB, Frankowski RF, Shedden P, et al: Surgical | ||
+ | treatment for intracerebral hemorrhage (STICH): a single-center, | ||
+ | randomized clinical trial. Neurology 51: | ||
+ | 91. Naff NJ, Wemmer J, Hoenig-Rigamonti K, et al: A longitudinal | ||
+ | study of patients with venous malformations: | ||
+ | of a negligible hemorrhage risk and benign natural history. | ||
+ | Neurology 50: | ||
+ | 92. Nath FP, Jenkins A, Mendelow AD, et al: Early hemodynamic | ||
+ | changes in experimental intracerebral hemorrhage. J Neurosurg | ||
+ | 65: | ||
+ | 93. Niizuma H, Shimizu Y, Yonemitsu T, et al: Results of stereotactic | ||
+ | aspiration in 175 cases of putaminal hemorrhage. Neurosurgery | ||
+ | 24: | ||
+ | 94. Niizuma H, Suzuki J, Yonemitsu T, et al: Spontaneous intracerebral | ||
+ | hemorrhage and liver dysfunction. Stroke | ||
+ | 19: | ||
+ | 95. O’Donnell HC, Rosand J, Knudsen KA, et al: Apolipoprotein E | ||
+ | genotype and the risk of recurrent lobar intracerebral hemorrhage. | ||
+ | N Engl J Med 342: | ||
+ | 96. Park P, Fewel ME, Thompson BG, et al: Recombinant activated | ||
+ | factor VII for the rapid correction of coagulopathy in nonhemophilic | ||
+ | neurosurgical patients. Neurosurgery 53:34–39, | ||
+ | 2003 | ||
+ | 97. Passero S, Rocchi R, Rossi S, et al: Seizures after spontaneous | ||
+ | supratentorial intracerebral hemorrhage. Epilepsia 43: | ||
+ | 1175–1180, | ||
+ | 98. Patel MR, Edelman RR, Warach S: Detection of hyperacute primary | ||
+ | intraparenchymal hemorrhage by magnetic resonance | ||
+ | imaging. Stroke 27: | ||
+ | 99. Poungvarin N, Bhoopat W, Viriyavejakul A, et al: Effects of | ||
+ | dexamethasone in primary supratentorial intracerebral hemorrhage. | ||
+ | N Engl J Med 316: | ||
+ | 100. Powers WJ, Adams RE, Yundt KD, et al: Acute pharmacological | ||
+ | hypotension after intracerebral hemorrhage does not | ||
+ | change cerebral blood flow. Stroke 30:242, 1999 (Abstract) | ||
+ | 101. Prasad K, Shrivastava A: Surgery for primary supratentorial | ||
+ | intracerebral haemorrhage. Cochrane Database Syst Rev 2: | ||
+ | 2000 | ||
+ | 102. Qureshi AI, Bliwise DL, Bliwise NG, et al: Rate of 24-hour | ||
+ | blood pressure decline and mortality after spontaneous intracerebral | ||
+ | hemorrhage: a retrospective analysis with a random | ||
+ | effects regression model. Crit Care Med 27: | ||
+ | 103. Qureshi AI, Hanel RA, Kirmani JF, et al: Cerebral blood flow | ||
+ | changes associated with intracerebral hemorrhage. Neurosurg | ||
+ | Clin N Am 13: | ||
+ | 104. Qureshi AI, Suri MF, Ostrow PT, et al: Apoptosis as a form | ||
+ | of cell death in intracerebral hemorrhage. Neurosurgery 52: | ||
+ | 1041–1048, | ||
+ | 105. Qureshi AI, Wilson DA, Hanley DF, et al: Pharmacological | ||
+ | reduction of mean arterial pressure does not adversely effect | ||
+ | regional cerebral blood flow and intracranial pressure in | ||
+ | experimental intracerebral hemorrhage. Crit Care Med | ||
+ | 27: | ||
+ | 106. Roda JM, Carceller F, Perez-Higueras A, et al: Encapsulated | ||
+ | intracerebral hematomas: a defined entity. Case report. J Neurosurg | ||
+ | 78: | ||
+ | 107. Rohde V, Rohde I, Reinges MH, et al: Frameless stereotactically | ||
+ | guided catheter placement and fibrinolytic therapy for | ||
+ | spontaneous intracerebral hematomas: technical aspects and | ||
+ | initial clinical results. Minim Invas Neurosurg 43:9–17, | ||
+ | 2000 | ||
+ | 108. Rosner MJ, Becker DP: Origin and evolution of plateau waves. | ||
+ | Experimental observations and a theoretical model. J Neurosurg | ||
+ | 60: | ||
+ | 109. Ruiz-Sandoval JL, Cantu C, Barinagarrementeria F: Intracerebral | ||
+ | hemorrhage in young people: analysis of risk factors, | ||
+ | location, causes, and prognosis. Stroke 30: | ||
+ | 110. Schaller C, Rohde V, Meyer B, et al: Stereotactic puncture | ||
+ | and lysis of spontaneous intracerebral hemorrhage using recombinant | ||
+ | tissue-plasminogen activator. Neurosurgery 36: | ||
+ | 328–335, 1995 | ||
+ | 111. Schellinger PD, Fiebach JB, Hoffmann K, et al: Stroke MRI in | ||
+ | intracerebral hemorrhage: is there a perihemorrhagic penumbra? | ||
+ | Stroke 34: | ||
+ | 112. Schellinger PD, Jansen O, Fiebach JB, et al: A standardized | ||
+ | MRI stroke protocol: comparison with CT in hyperacute | ||
+ | intracerebral hemorrhage. Stroke 30: | ||
+ | 113. SHEP Cooperative Research Group: Prevention of stroke by | ||
+ | antihypertensive drug treatment in older persons with isolated | ||
+ | systolic hypertension. Final results of the Systolic Hypertension | ||
+ | in the Elderly Program (SHEP). JAMA 265: | ||
+ | 3255–3264, | ||
+ | 114. Siddique MS, Fernandes HM, Wooldridge TD, et al: Reversible | ||
+ | ischemia around intracerebral hemorrhage: a singlephoton | ||
+ | emission computerized tomography study. J Neurosurg | ||
+ | 96: | ||
+ | 115. Strandgaard S, Olesen J, Skinhoj E, et al: Autoregulation of | ||
+ | brain circulation in severe arterial hypertension. Br Med J | ||
+ | 1: | ||
+ | 116. Sung CY, Chu NS: Epileptic seizures in intracerebral haemorrhage. | ||
+ | J Neurol Neurosurg Psychiatry 52: | ||
+ | 117. Suzuki J, Kodama N: Moyamoya disease—a review. Stroke | ||
+ | 14: | ||
+ | 118. Suzuki K, Kutsuzawa T, Takita K, et al: Clinico-epidemiologic | ||
+ | study of stroke in Akita, Japan. Stroke 18: | ||
+ | 119. Taylor TN, Davis PH, Torner JC: Projected number of strokes | ||
+ | by subtype in the year 2050 in the United States. Stroke | ||
+ | 29:322 1998 (Abstract) | ||
+ | 120. Teernstra OP, Evers SM, Lodder J, et al: Stereotactic treatment | ||
+ | of intracerebral hematoma by means of a plasminogen activator: | ||
+ | a multicenter randomized controlled trial (SICHPA). | ||
+ | Stroke 34: | ||
+ | 121. Tellez H, Bauer RB: Dexamethasone as treatment in cerebrovascular | ||
+ | disease. 1. A controlled study in intracerebral hemorrhage. | ||
+ | Stroke 4: | ||
+ | 122. Thrift AG, McNeil JJ, Forbes A, et al: Risk factors for cerebral | ||
+ | hemorrhage in the era of well-controlled hypertension. Melbourne | ||
+ | Risk Factor Study (MERFS) Group. Stroke 27: | ||
+ | 2020–2025, | ||
+ | 123. Tuhrim S, Horowitz DR, Sacher M, et al: Volume of ventricular | ||
+ | blood is an important determinant of outcome in supratentorial | ||
+ | intracerebral hemorrhage. Crit Care Med 27: | ||
+ | 1999 | ||
+ | 124. Uemura K, Higano S, Shishido F, et al: Regional cerebral blood | ||
+ | flow and oxygen metabolism in patients with hypertensive | ||
+ | intracerebral hemorrhage. A PET study in 23 patients. J Cereb | ||
+ | Blood Flow Metab 7 (Suppl 1):S32, 1987 (Abstract) | ||
+ | 125. van Loon J, Van Calenbergh F, Goffin J, et al: Controversies in | ||
+ | the management of spontaneous cerebellar haemorrhage. A | ||
+ | consecutive series of 49 cases and review of the literature. | ||
+ | Acta Neurochir 122: | ||
+ | 126. Vinters HV: Cerebral amyloid angiopathy. A critical review. | ||
+ | Stroke 18: | ||
+ | 127. Wagner KR, Xi G, Hua Y, et al: Ultra-early clot aspiration after | ||
+ | lysis with tissue plasminogen activator in a porcine model of | ||
+ | intracerebral hemorrhage: edema and blood—brain barrier | ||
+ | protection. J Neurosurg 90: | ||
+ | 128. Weir CJ, Murray GD, Adams FG, et al: Poor accuracy of scoring | ||
+ | systems for differential clinical diagnosis of intracranial | ||
+ | haemorrhage and infarction. Lancet 344: | ||
+ | 129. Xi G, Keep RF, Hoff JT: Pathophysiology of brain edema formation. | ||
+ | Neurosurg Clin N Am 13: | ||
+ | 130. Xi G, Reiser G, Keep RF: The role of thrombin and thrombin | ||
+ | receptors in ischemic, hemorrhagic, | ||
+ | deleterious or protective? J Neurochem 84:3–9, 2003 | ||
+ | 131. Xi G, Wagner KR, Keep RF, et al: Role of blood clot formation | ||
+ | on early edema development after experimental intracerebral | ||
+ | hemorrhage. Stroke 29: | ||
+ | 132. Yanaka K, Meguro K, Fujita K, et al: Immediate surgery reduces | ||
+ | mortality in deeply comatose patients with spontaneous | ||
+ | cerebellar hemorrhage. Neurol Med Chir 40: | ||
+ | 133. Yang GY, Betz AL, Chenevert TL, et al: Experimental intracerebral | ||
+ | hemorrhage: relationship between brain edema, blood | ||
+ | flow, and blood-brain barrier permeability in rats. J Neurosurg | ||
+ | 81: | ||
+ | 134. Yoshida Y, Yoshimoto T, Shirane R, et al: Clinical course, surgical | ||
+ | management, and long-term outcome of moyamoya patients | ||
+ | with rebleeding after an episode of intracerebral hemorrhage: | ||
+ | an extensive follow-up study. Stroke 30: | ||
+ | 1999 | ||
+ | 135. Yu YL, Kumana CR, Lauder IJ, et al: Treatment of acute cerebral | ||
+ | hemorrhage with intravenous glycerol. A double-blind, | ||
+ | placebo-controlled, | ||
+ | 1992 | ||
+ | 136. Zazulia AR, Diringer MN, Videen TO, et al: Hypoperfusion | ||
+ | without ischemia surrounding acute intracerebral hemorrhage. | ||
+ | J Cereb Blood Flow Metab 21: | ||
+ | 137. Zhu XL, Chan MS, Poon WS: Spontaneous intracranial hemorrhage: | ||
+ | which patients need diagnostic cerebral angiography? | ||
+ | A prospective study of 206 cases and review of the literature. | ||
+ | Stroke 28: | ||
+ | 138. Zuccarello M, Brott T, Derex L, et al: Early surgical treatment | ||
+ | for supratentorial intracerebral hemorrhage: a randomized feasibility | ||
+ | study. Stroke 30: | ||
+ | |||
+ | |||
+ | La [[hemorragia cerebral]] espontánea, | ||
+ | |||
+ | ====Epidemiología==== | ||
+ | Es el segundo subtipo más común de [[accidente cerebrovascular]], | ||
+ | |||
+ | En el 2001, la incidencia anual era de 20-30 por 1.000.000 personas | ||
+ | |||
+ | |||
+ | ====Clasificación==== | ||
+ | Según su localización puede ser intraparenquimatosa o intraventricular (HV). | ||
+ | |||
+ | ====Etiología==== | ||
+ | Hipertensión arterial | ||
+ | |||
+ | [[Hemorragia cerebral por malformación arteriovenosa cerebral]]. | ||
+ | |||
+ | Aneurismas (saculares. micóticos) | ||
+ | |||
+ | MAV. | ||
+ | |||
+ | Fístula arteriovenosa | ||
+ | |||
+ | Angioma venoso | ||
+ | |||
+ | Cavernoma | ||
+ | |||
+ | Telangiectasia | ||
+ | |||
+ | Enfermedades hematológicas | ||
+ | |||
+ | Afibrinogenemia | ||
+ | |||
+ | Déficit de factor de von Willebrand | ||
+ | |||
+ | Púrpura trombótica trombocitopénica idiopática | ||
+ | |||
+ | Leucemia | ||
+ | |||
+ | Síndrome de hiperviscosidad | ||
+ | |||
+ | Mieloma múltiple | ||
+ | |||
+ | Coagulación intravascular diseminada | ||
+ | |||
+ | Trombopenias primarias o secundarias a fármacos | ||
+ | |||
+ | Angiopatía cerebral amiloidea | ||
+ | |||
+ | Vasculitis multisistémica aislada del sistema nervioso central | ||
+ | |||
+ | Síndrome de Moyamoya | ||
+ | |||
+ | Trombosis venosa central | ||
+ | |||
+ | Tumores: primarios y metastásicos | ||
+ | |||
+ | Enfermedades infecciosas | ||
+ | |||
+ | Tuberculosis | ||
+ | |||
+ | Brucelosis | ||
+ | |||
+ | Leptospirosis | ||
+ | |||
+ | Micosis | ||
+ | |||
+ | Simpaticomiméticos | ||
+ | |||
+ | Anfetaminas (anfetamina. metanfetamina) | ||
+ | |||
+ | Cocaína | ||
+ | |||
+ | Crack | ||
+ | |||
+ | Norefedrina. efedrina. fenciclidina Fibrinolíticos | ||
+ | |||
+ | ===== Recomendaciones ===== | ||
+ | |||
+ | ver [[Recomendaciones en hemorragia cerebral espontánea]] |