Browse by author
Lookup NU author(s): Helen Fernandes,
Emeritus Professor David Mendelow
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
The optimal management, surgical or otherwise, of a patient following a spontaneous intracerebral haemorrhage (ICH) remains controversial. A survey of British neurosurgeons was carried out to assess current attitudes and practice. Patient management was most consistently influenced by the depth (71% agreement), dominance (74.3% agreement) and site (44.7%) of the haematoma. Almost half of neurosurgeons said they would evacuate an ICH in a deteriorating patient, but management choice was very varied in stable patients. However, 80% of the same respondents felt evacuation was helpful in reducing mortality, and 71.3% morbidity. Fifteen per cent of respondents were not influenced by the size of an ICH, but 31% would readily operate on haematomas with volumes of between 50 and 80 mi. Over 30% felt that there was no optimal time for surgical evacuation, but 66.9% felt delayed evacuation was helpful. Premorbid dependency was a stronger influence than age on management choice. Despite these variations, over half felt that they were consistent in their treatment of ICH. However, 81% expressed surgical uncertainty. Furthermore, respondents demonstrated a significant tendency to intervene surgically more readily in ICH related to aneurysm or AVM. Results from a prospective randomized controlled trial to assess the role of surgery are urgently needed.
Author(s): Mendelow AD; Fernandes HM
Publication type: Article
Publication status: Published
Journal: British Journal of Neurosurgery
Print publication date: 01/08/1999
ISSN (print): 0268-8697
ISSN (electronic): 1360-046X
Publisher: Informa Healthcare
Altmetrics provided by Altmetric