European Stroke Organisation (ESO) Guidelines for the Management of Spontaneous Intracerebral Hemorrhage
-
- Thorsten Steiner
- Department of Neurology, Klinikum Frankfurt Höchst, Frankfurt, Germany
-
- Rustam Al-Shahi Salman
- Division of Clinical Neurosciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
-
- Ronnie Beer
- Department of Neurology, Neurointensive Care Unit, Medical University Hospital, Innsbruck, Austria
-
- Hanne Christensen
- Department of Neurology, Bispebjerg Hospital, University of Copenhagen, Denmark
-
- Charlotte Cordonnier
- Department of Neurology, EA 1046, Université Lille Nord de France, Lille, France
-
- Laszlo Csiba
- Department of Neurology, Clinical Center, Debrecen University, Hungary
-
- Michael Forsting
- Department of Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
-
- Sagi Harnof
- Department of Neurosurgery, Sheba Medical Center, Tel Aviv, Israel
-
- Catharina J. M. Klijn
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
-
- Derk Krieger
- Department of Neurology, Bispebjerg Hospital, University of Copenhagen, Denmark
-
- A. David Mendelow
- Institute of Neurosciences, Newcastle University, Newcastle, UK
-
- Carlos Molina
- Department of Neurology, Hospital Universitari Vall d'Hebrón, Barcelona, Spain
-
- Joan Montaner
- Department of Neurology, Hospital Universitari Vall d'Hebrón, Barcelona, Spain
-
- Karsten Overgaard
- Department of Neurology, Bispebjerg Hospital, University of Copenhagen, Denmark
-
- Jesper Petersson
- Department of Neurology, Skåne University Hospital, Malmö, Sweden
-
- Risto O. Roine
- Division of Clinical Neurosciences, Turku University Hospital and University of Turku, Turku, Finland
-
- Erich Schmutzhard
- Department of Neurology, Neurointensive Care Unit, Medical University Hospital, Innsbruck, Austria
-
- Karsten Schwerdtfeger
- Department of Neurosurgery, Saarland University Hospital, Homburg-Saar, Germany
-
- Christian Stapf
- Department of Neurology, Hôpital Lariboisière, Université Paris VII – Denis Diderot, Paris, France
-
- Turgut Tatlisumak
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
-
- Brenda M. Thomas
- Cochrane Stroke Group, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
-
- Danilo Toni
- Depatment of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
-
- Andreas Unterberg
- Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
-
- Markus Wagner
- Stiftung Deutsche Schlaganfall-Hilfe, Gütersloh, Germany
抄録
<jats:sec><jats:title>Background</jats:title><jats:p> Intracerebral hemorrhage (ICH) accounted for 9% to 27% of all strokes worldwide in the last decade, with high early case fatality and poor functional outcome. In view of recent randomized controlled trials (RCTs) of the management of ICH, the European Stroke Organisation (ESO) has updated its evidence-based guidelines for the management of ICH. </jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p> A multidisciplinary writing committee of 24 researchers from 11 European countries identified 20 questions relating to ICH management and created recommendations based on the evidence in RCTs using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> We found moderate- to high-quality evidence to support strong recommendations for managing patients with acute ICH on an acute stroke unit, avoiding hemostatic therapy for acute ICH not associated with antithrombotic drug use, avoiding graduated compression stockings, using intermittent pneumatic compression in immobile patients, and using blood pressure lowering for secondary prevention. We found moderate-quality evidence to support weak recommendations for intensive lowering of systolic blood pressure to <140 mmHg within six-hours of ICH onset, early surgery for patients with a Glasgow Coma Scale score 9–12, and avoidance of corticosteroids. </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> These guidelines inform the management of ICH based on evidence for the effects of treatments in RCTs. Outcome after ICH remains poor, prioritizing further RCTs of interventions to improve outcome. </jats:p></jats:sec>
収録刊行物
-
- International Journal of Stroke
-
International Journal of Stroke 9 (7), 840-855, 2014-08-24
SAGE Publications