الفهرس 
Pathophysiology of spontaneous ICH
HypertensionOnly 14 pages are availabe for public view
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Abstract
Spontaneous ICH is a major life threatening condition.
Spontaneous supratentorial intracerebral haemorrhage affects 20
in 100 000 people every year with a mortality of more than 40%.
Most survivors are disabled. The management of such cases is
difficult with many controversies. The major controversy is
whether these cases benefit from surgical intervention or not and
if so, what are the selection criteria? What is the best approach?
In our study we analysed the effect of surgical versus
medical treatment on outcome (mortality/morbidity) of 11 studies
after a supratentorial spontaneous ICH which indicate a
significant increase (p=0. 0.005) in the mortality rate in the
conservatively managed group and a better functional outcome in
the surgically managed group (p=0. 0.001).
We conclude that surgical evacuation for spontaneous
supratentorial ICH is to be the preferred choice of treatment for
the cases GCS≥6 and for large hematomas (>30ml volume). Early
surgery especially within 24 hours improves surgical results.
Although craniotomy is the most preferred method, endoscopic
technique seems to provide decreased morbidity and mortality
rates. However the studies are not enough to analyze the best
surgical type.