Author/Editor		Menih, Marija
Title		Obravnava bolnikov z znotrajmožgansko krvavitvijo v okviru smernic
Translated title		Management of patients with intracerebral bleeding within the guidelines
Type		članek
Source		In: Akutna možganska kap VII : učbenik za zdravnike in zdravstvene delavce Ljubljana : Društvo za preprečevanje možganskih in žilnih bolezni
Publication year		2012
Volume		str. 123-133
Language		slv
Abstract		Spontana znotrajmožganska krvavitev je pomemben vzrok zbolevnosti in umrljivosti v svetu. Takojšnja intenzivna zdravstvena oskrba ima močan in neposreden vpliv na izid in preživetje bolnikov. Številne objavljene in dokončane raziskave s področja zdravljenja in kirurške obravnave znotrajmožganskih krvavitev ponujajo znanje, osnovano na dokazih. Namen smernic je predstaviti nova in z dokazi podprta priporočila za diagnozo, zdravstveno in kirurško obravnavo, prognozo, rehabilitacijo in preprečevanje ponovne krvavitve. Vendar je obravnava globoko ležečih možganskih krvavitev še vedno predmet razprave med nevrologi in kirurgi, in to na ravni indikacij, časovnega okvira ter kirurške metode. Zgodnja endoskopska odstanitev hematoma je obetavna kirurška metoda, pri kateri je poškodba normalnega možganskega tkiva minimalna v primerjavi s klasično kraniotomijo. Neznatno invazivna kirurška metoda zagotavlja tudi manj ponovnih krvavitev, manjši sta tudi zbolevnost in smrtnost glede na kraniotomijo. Velike randomizirane klinične raziskave, ki še potekajo o antihipertenzivnem zdravljenju in kirurški odstranitvi hematoma, bodo v prihodnosti zagotovile nov način obravnave bolnikov z znotrajmožgansko krvavitvijo.Spontaneous intracerebral hemorrhage is a significant cause of morbidity and mortality in the world. Acute intensive medical care has a strong and direct impact on outcome and survival of patients. There are many published medical and surgical trials for intracerebral hemorrhage that have been completed and they offer and evidence based knowledge. The purpose of guidelines is to present up-to-date and evidence based recommendations for the diagnosis, medical and surgical treatment, prognosis, rehabilitation and prevention of recurrent bleeding. However, the management of deep brain hematomas is still a matter of debate among neurologists and surgeons with regard to indications, time frame, and surgical methods. Promising surgical methods is a nearly endoscope-assisted evacuation of hematoma with minimal damage to normal brain tissue compared to traditional craniotomy. Minimally invasive surgical method provides also low rates of rebleeding, morbidity and mortality compared to craniotomy. Ongoing large randomized clinical studies on antihypertensive therapy and surgical removal of haematoma will provide new approach in the management of patients with intracerebral hemorrhages in the future.
Descriptors		Cerebral Hemorrhage Možganska krvavitev Diagnosis Therapy Surgery Prevention and Control Rehabilitation Diagnostika Zdravljenje Kirurgija Preprečevanje in nadzor Rehabilitacija