New avenues for treatment of intracranial hemorrhage
Shruti Sonni, Vasileios-Arsenios Lioutas, Magdy H Selim, Shruti Sonni, Vasileios-Arsenios Lioutas, Magdy H Selim
Abstract
The mortality and morbidity from intracerebral hemorrhage (ICH) remain high despite advances in medical, neurologic, and surgical care during the past decade. The lessons learned from previous therapeutic trials in ICH, improved understanding of the pathophysiology of neuronal injury after ICH, and advances in imaging and pre-hospital assessment technologies provide optimism that more effective therapies for ICH are likely to emerge in the coming years. The potential new avenues for the treatment of ICH include a combination of increased utilization of minimally invasive surgical techniques with or without thrombolytic usage to evacuate or reduce the size of the hematoma; utilization of advanced imaging to improve selection of patients who are likely to benefit from reversal of coagulopathy or hemostatic therapy; ultra-early diagnosis and initiation of therapy in the ambulance; and the use of novel drugs to target the secondary injury mechanisms, including the inflammatory cascade, perihematomal edema reduction, and hemoglobin degradation products-mediated toxicity.
Conflict of interest statement
Conflict of Interest
Dr. Shruti Sonni declares no potential conflicts of interest relevant to this article.
Dr. Vasileios-Arsenios Lioutas declares no potential conflicts of interest relevant to this article.
Dr. Magdy H. Selim is the principal investigator for a NINDS-sponsored trial (U01 NS074425).
Source: PubMed