Materiały źródłowe

• #1 Intracranial hematoma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intracranial-hematoma/symptoms-causes/syc-20356145

  An intracranial hematoma is potentially life-threatening. It usually requires immediate treatment. This might include surgery to remove the blood. […] All three types require medical attention as soon as symptoms appear. Prompt medical care may prevent permanent brain damage. […] An epidural hematoma that affects an artery in your brain can be deadly without prompt treatment. […] To prevent or minimize a head injury that may cause an intracranial hematoma: Wear a helmet and make sure your kids wear helmets.

• #2 Brain Bleed (Intracranial Hemorrhage): Causes & Symptoms

  https://my.clevelandclinic.org/health/diseases/14480-brain-bleed-hemorrhage-intracranial-hemorrhage

  A brain bleed (intracranial hemorrhage) is a life-threatening medical emergency. It only takes three to four minutes for your brain cells to die if they don’t receive enough oxygen. Treating a brain bleed quickly leads to the best outcome. […] Treatment for a brain bleed varies based on the severity and location of the bleed. Your healthcare provider will focus on stopping the bleeding and managing the cause. Treatment may include: Surgery. Medications. […] Surgery can treat a brain bleed to stop bleeding and address the underlying cause. Surgery may include: Decompression: A surgeon will drill a hole in your skull to drain blood and relieve pressure. Craniectomy: A surgeon will remove a piece of your skull to relieve pressure. Once your skull is open, your surgeon can treat the source of the brain bleed. Craniotomy: A surgeon will remove and replace a piece of your skull to relieve pressure and manage the source of bleeding.

• #3 Intracranial hematoma | Altru Health System

  https://www.altru.org/health-library/conditions/intracranial-hematoma

  Intracranial hematomas that are small and produce no symptoms don’t need to be removed. However, symptoms can appear or worsen days or weeks after the injury. As a result, you might have to be watched for neurological changes, have your intracranial pressure monitored and undergo repeated head CT scans. […] If you take blood-thinning medicine, such as warfarin (Jantoven), you may need therapy to reverse the effects of the medicine. This will reduce the risk of further bleeding. Options for reversing blood thinners include giving vitamin K and fresh frozen plasma. […] Intracranial hematoma treatment often involves surgery. The type of surgery depends on the type of hematoma you have. Options include: […] Surgical drainage. If the blood is in one area and has changed from a solid clot to a liquid, your doctor might create a small hole in your skull and use suction to remove the liquid. […] Removing part of the skull, known as a craniotomy. Large hematomas might require that a section of your skull be opened to remove the blood.

• #4 Intracranial Hemorrhage – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470242/

  Immediate neurosurgical consultation is recommended for all hemorrhages, but mainly if alarming signs such as airway compromise, respiratory failure, or hemodynamic instability exist. […] Definitive treatment is an evacuation of the hematoma and stopping the bleeding source. Some smaller epidural hematomas may be managed non-surgically and monitored for resolution. […] Conservative management is attempted if the patient satisfies all of the following criteria and has mild symptoms: Epidural hematoma volume of less than 30 mL, a clot diameter of less than 15 mm, midline shift of less than 5 mm, GCS greater than 8 and, on physical examination, shows no focal neurological symptoms. […] Definitive treatment is an evacuation, but depending on the size and location, some subdural hematomas may be monitored for resolution. Non-surgical management options include repeat imaging to ensure subdural stability, anticoagulation reversal, platelet transfusions for thrombocytopenia or dysfunctional platelets, observation with frequent neurologic assessments for deterioration, and/or controlling hypertension.

• #5 Intracranial Hemorrhage – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470242/

  Immediate neurosurgical consultation is recommended for all hemorrhages, but mainly if alarming signs such as airway compromise, respiratory failure, or hemodynamic instability exist. […] Definitive treatment is an evacuation of the hematoma and stopping the bleeding source. Some smaller epidural hematomas may be managed non-surgically and monitored for resolution. […] Conservative management is attempted if the patient satisfies all of the following criteria and has mild symptoms: Epidural hematoma volume of less than 30 mL, a clot diameter of less than 15 mm, midline shift of less than 5 mm, GCS greater than 8 and, on physical examination, shows no focal neurological symptoms. […] Definitive treatment is an evacuation, but depending on the size and location, some subdural hematomas may be monitored for resolution. Non-surgical management options include repeat imaging to ensure subdural stability, anticoagulation reversal, platelet transfusions for thrombocytopenia or dysfunctional platelets, observation with frequent neurologic assessments for deterioration, and/or controlling hypertension.

• #6 Brain Bleed (Intracranial Hemorrhage): Causes & Symptoms

  https://my.clevelandclinic.org/health/diseases/14480-brain-bleed-hemorrhage-intracranial-hemorrhage

  Based on your diagnostic test results, a healthcare provider may prescribe the following medications to treat the symptoms, the underlying cause or prevent complications of a brain bleed: Anti-anxiety medications. Antiseizure medications. Blood pressure management medications. Pain relievers. Steroid medications (corticosteroids). Stool softeners (to prevent straining and pressure). […] You may need rehabilitation after a brain bleed. Depending on the severity of the bleed, brain damage is a possibility that can affect your ability to complete your daily routine. Rehabilitation can help you regain the functions needed for daily living and prevent future brain bleeds.

• #7 Intracranial Hemorrhage Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1163977-treatment

  Early treatment in patients presenting with spontaneous intracerebral hemorrhage is important as it may decrease hematoma enlargement and lead to better neurologic outcome. […] Initiate fosphenytoin or other anticonvulsant definitely for seizure activity or lobar hemorrhage, and optionally in other patients. Levetiracetam has shown efficacy in children for prophylaxis of early posthemorrhagic seizures. […] While reducing SBP with intravenous nicardipine hydrochloride does not significantly reduce hematoma expansion in patients with ICH, the Antihypertensive Treatment of Acute Cerebral Hemorrhage study supports further studies to evaluate the efficacy of aggressive pharmacologic SBP reduction. […] Consider surgery for patients with cerebellar hemorrhage greater than 3 cm, for patients with intracerebral hemorrhage associated with a structural vascular lesion, and for young patients with lobar hemorrhage. […] Surgical approaches include the following: Craniotomy and clot evacuation under direct visual guidance, Stereotactic aspiration with thrombolytic agents, Endoscopic evacuation.

• #8 Intracranial Hemorrhage Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1163977-treatment

  Early treatment in patients presenting with spontaneous intracerebral hemorrhage is important as it may decrease hematoma enlargement and lead to better neurologic outcome. […] Initiate fosphenytoin or other anticonvulsant definitely for seizure activity or lobar hemorrhage, and optionally in other patients. Levetiracetam has shown efficacy in children for prophylaxis of early posthemorrhagic seizures. […] While reducing SBP with intravenous nicardipine hydrochloride does not significantly reduce hematoma expansion in patients with ICH, the Antihypertensive Treatment of Acute Cerebral Hemorrhage study supports further studies to evaluate the efficacy of aggressive pharmacologic SBP reduction. […] Consider surgery for patients with cerebellar hemorrhage greater than 3 cm, for patients with intracerebral hemorrhage associated with a structural vascular lesion, and for young patients with lobar hemorrhage. […] Surgical approaches include the following: Craniotomy and clot evacuation under direct visual guidance, Stereotactic aspiration with thrombolytic agents, Endoscopic evacuation.

• #9 Intracranial Hemorrhage Medication: Antihypertensive agents, Osmotic diuretics, Antipyretics, analgesics, Anticonvulsants, Antidotes, Antacids

  https://emedicine.medscape.com/article/1163977-medication

  Antihypertensive agents reduce blood pressure to prevent exacerbation of intracerebral hemorrhage. Osmotic diuretics, such as mannitol, may be used to decrease intracranial pressure. […] As hyperthermia may exacerbate neurological injury, acetaminophen may be given to reduce fever and to relieve headache. […] Anticonvulsants are used routinely to avoid seizures that may be induced by cortical damage. Levetiracetam has shown efficacy in children for prophylaxis of early posthemorrhagic seizures. […] Additional data suggest that levetiracetam is more effective than phenytoin for seizure prophylaxis without suppression of cognitive abilities in patients with ICH. […] Vitamin K and protamine may be used to restore normal coagulation parameters. Antacids are used to prevent gastric ulcers associated with intracerebral hemorrhage.

• #10 Brain Bleed (Intracranial Hemorrhage): Causes & Symptoms

  https://my.clevelandclinic.org/health/diseases/14480-brain-bleed-hemorrhage-intracranial-hemorrhage

  Based on your diagnostic test results, a healthcare provider may prescribe the following medications to treat the symptoms, the underlying cause or prevent complications of a brain bleed: Anti-anxiety medications. Antiseizure medications. Blood pressure management medications. Pain relievers. Steroid medications (corticosteroids). Stool softeners (to prevent straining and pressure). […] You may need rehabilitation after a brain bleed. Depending on the severity of the bleed, brain damage is a possibility that can affect your ability to complete your daily routine. Rehabilitation can help you regain the functions needed for daily living and prevent future brain bleeds.

• #11 Brain Bleed (Intracranial Hemorrhage): Causes & Symptoms

  https://my.clevelandclinic.org/health/diseases/14480-brain-bleed-hemorrhage-intracranial-hemorrhage

  Based on your diagnostic test results, a healthcare provider may prescribe the following medications to treat the symptoms, the underlying cause or prevent complications of a brain bleed: Anti-anxiety medications. Antiseizure medications. Blood pressure management medications. Pain relievers. Steroid medications (corticosteroids). Stool softeners (to prevent straining and pressure). […] You may need rehabilitation after a brain bleed. Depending on the severity of the bleed, brain damage is a possibility that can affect your ability to complete your daily routine. Rehabilitation can help you regain the functions needed for daily living and prevent future brain bleeds.

• #12 New avenues for treatment of intracranial hemorrhage

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3932437/

  Given the neutral effects of craniotomy and hematoma evacuation and the inherent risks of a surgical approach, especially for hemorrhages with a deep parenchymal location, minimally invasive methods are now the subject of vigorous investigations. […] Overall, there is guarded optimism that minimally invasive aspiration of the clot with local t-PA alone or in combination with ultrasound could provide a successful strategy to treat ICH in the future if the results of planned phase III trials support its safety and efficacy. […] Hematoma expansion (HE) remains a major target to minimize neurological deterioration and decrease morbidity and mortality after ICH. […] The Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage (INTERACT) and the Antihypertensive Treatment in Acute Cerebral Hemorrhage (ATACH) trials showed that early intensive systolic blood pressure lowering to less than 140 mm Hg is clinically feasible, well tolerated, and seems to reduce HE in ICH.

• #13 Brain Bleed (Intracranial Hemorrhage): Causes & Symptoms

  https://my.clevelandclinic.org/health/diseases/14480-brain-bleed-hemorrhage-intracranial-hemorrhage

  Based on your diagnostic test results, a healthcare provider may prescribe the following medications to treat the symptoms, the underlying cause or prevent complications of a brain bleed: Anti-anxiety medications. Antiseizure medications. Blood pressure management medications. Pain relievers. Steroid medications (corticosteroids). Stool softeners (to prevent straining and pressure). […] You may need rehabilitation after a brain bleed. Depending on the severity of the bleed, brain damage is a possibility that can affect your ability to complete your daily routine. Rehabilitation can help you regain the functions needed for daily living and prevent future brain bleeds.

• #14 Brain Bleed (Intracranial Hemorrhage): Causes & Symptoms

  https://my.clevelandclinic.org/health/diseases/14480-brain-bleed-hemorrhage-intracranial-hemorrhage

  Based on your diagnostic test results, a healthcare provider may prescribe the following medications to treat the symptoms, the underlying cause or prevent complications of a brain bleed: Anti-anxiety medications. Antiseizure medications. Blood pressure management medications. Pain relievers. Steroid medications (corticosteroids). Stool softeners (to prevent straining and pressure). […] You may need rehabilitation after a brain bleed. Depending on the severity of the bleed, brain damage is a possibility that can affect your ability to complete your daily routine. Rehabilitation can help you regain the functions needed for daily living and prevent future brain bleeds.

• #15 Intracerebral hemorrhage – Wikipedia

  https://en.wikipedia.org/wiki/Intracerebral_hemorrhage

  The specific reversal agents idarucizumab and andexanet alfa may be used to stop continued intracerebral hemorrhage in people taking directly oral acting anticoagulants (such as factor Xa inhibitors or direct thrombin inhibitors). […] Corticosteroids were thought to reduce swelling. However, in large controlled studies, corticosteroids have been found to increase mortality rates and are no longer recommended.

• #16 Intracranial hematoma | Altru Health System

  https://www.altru.org/health-library/conditions/intracranial-hematoma

  Intracranial hematomas that are small and produce no symptoms don’t need to be removed. However, symptoms can appear or worsen days or weeks after the injury. As a result, you might have to be watched for neurological changes, have your intracranial pressure monitored and undergo repeated head CT scans. […] If you take blood-thinning medicine, such as warfarin (Jantoven), you may need therapy to reverse the effects of the medicine. This will reduce the risk of further bleeding. Options for reversing blood thinners include giving vitamin K and fresh frozen plasma. […] Intracranial hematoma treatment often involves surgery. The type of surgery depends on the type of hematoma you have. Options include: […] Surgical drainage. If the blood is in one area and has changed from a solid clot to a liquid, your doctor might create a small hole in your skull and use suction to remove the liquid. […] Removing part of the skull, known as a craniotomy. Large hematomas might require that a section of your skull be opened to remove the blood.

• #17 Intracranial Hemorrhage – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470242/

  If the patient is on anticoagulation or antiplatelet agents, reversal is prioritized. Management is typically conservative with close assessments of vitals and neurologic status. […] Blood pressure should be monitored to decrease the risk of further hemorrhage. The treatment depends on the etiology of the hemorrhage. Treatment options are variable and include aggressive surgical evacuation, craniectomy, catheter-based dissolution, or observation.

• #18 Intracerebral hemorrhage – Wikipedia

  https://en.wikipedia.org/wiki/Intracerebral_hemorrhage

  The specific reversal agents idarucizumab and andexanet alfa may be used to stop continued intracerebral hemorrhage in people taking directly oral acting anticoagulants (such as factor Xa inhibitors or direct thrombin inhibitors). […] Corticosteroids were thought to reduce swelling. However, in large controlled studies, corticosteroids have been found to increase mortality rates and are no longer recommended.

• #19 Intracranial hematoma | Altru Health System

  https://www.altru.org/health-library/conditions/intracranial-hematoma

  Intracranial hematomas that are small and produce no symptoms don’t need to be removed. However, symptoms can appear or worsen days or weeks after the injury. As a result, you might have to be watched for neurological changes, have your intracranial pressure monitored and undergo repeated head CT scans. […] If you take blood-thinning medicine, such as warfarin (Jantoven), you may need therapy to reverse the effects of the medicine. This will reduce the risk of further bleeding. Options for reversing blood thinners include giving vitamin K and fresh frozen plasma. […] Intracranial hematoma treatment often involves surgery. The type of surgery depends on the type of hematoma you have. Options include: […] Surgical drainage. If the blood is in one area and has changed from a solid clot to a liquid, your doctor might create a small hole in your skull and use suction to remove the liquid. […] Removing part of the skull, known as a craniotomy. Large hematomas might require that a section of your skull be opened to remove the blood.

• #20 Intracranial Hematomas – Injuries and Poisoning – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/injuries-and-poisoning/head-injuries/intracranial-hematomas

  Sometimes surgery is needed to drain blood from a hematoma. […] Treatment of intracranial hematomas depends on the type and size of the hematoma and how much pressure has built up in the brain. […] Doctors treat epidural hematomas as soon as they are diagnosed. Prompt treatment is necessary to prevent permanent damage. Usually, 1 or more holes are drilled in the skull to drain the excess blood. The surgeon also seeks the source of the bleeding and stops the bleeding. […] For small hematomas, often no treatment. […] For large hematomas, surgery to drain them. […] If a subdural hematoma is large and is causing symptoms such as persistent headache, fluctuating drowsiness, confusion, memory changes, and paralysis on the opposite side of the body, doctors usually drain it surgically, sometimes by drilling a small hole in the skull. However, sometimes a larger opening must be made in the skull for example, when bleeding has occurred very recently or when the blood may be too thick to drain through a small hole.

• #21 Intracranial Hemorrhage Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1163977-treatment

  Early treatment in patients presenting with spontaneous intracerebral hemorrhage is important as it may decrease hematoma enlargement and lead to better neurologic outcome. […] Initiate fosphenytoin or other anticonvulsant definitely for seizure activity or lobar hemorrhage, and optionally in other patients. Levetiracetam has shown efficacy in children for prophylaxis of early posthemorrhagic seizures. […] While reducing SBP with intravenous nicardipine hydrochloride does not significantly reduce hematoma expansion in patients with ICH, the Antihypertensive Treatment of Acute Cerebral Hemorrhage study supports further studies to evaluate the efficacy of aggressive pharmacologic SBP reduction. […] Consider surgery for patients with cerebellar hemorrhage greater than 3 cm, for patients with intracerebral hemorrhage associated with a structural vascular lesion, and for young patients with lobar hemorrhage. […] Surgical approaches include the following: Craniotomy and clot evacuation under direct visual guidance, Stereotactic aspiration with thrombolytic agents, Endoscopic evacuation.

• #22 Intracerebral Hemorrhage – AANS

  https://www.aans.org/patients/conditions-treatments/intracerebral-hemorrhage/

  Treatment focusses on stopping the bleeding, removing the clot and relieving pressure on the brain. If left alone, the brain will eventually re-absorb the clot. The damage done by increased brain pressure over a long period may be irreversible. […] Non-surgical treatments include: Clotting factor administration, if patient was on blood thinners; Blood pressure control to reduce risk of more bleeding; and Measuring and controlling ICP (pressure on brain tissue due to clot). […] Surgical treatments include: A craniotomy involves removing a piece of the skull bone and exposing the brain to remove the clot. It is useful when the clot is close to the surface of the brain or if the clot is associated with an underlying brain lesion. Stereotactic clot aspiration is a minimally invasive technique to evacuate a clot located deep inside the brain. This is possible with use of neuronavigation technology, which works similar to GPS in cars.

• #23 Intracranial hematoma | Altru Health System

  https://www.altru.org/health-library/conditions/intracranial-hematoma

  Intracranial hematomas that are small and produce no symptoms don’t need to be removed. However, symptoms can appear or worsen days or weeks after the injury. As a result, you might have to be watched for neurological changes, have your intracranial pressure monitored and undergo repeated head CT scans. […] If you take blood-thinning medicine, such as warfarin (Jantoven), you may need therapy to reverse the effects of the medicine. This will reduce the risk of further bleeding. Options for reversing blood thinners include giving vitamin K and fresh frozen plasma. […] Intracranial hematoma treatment often involves surgery. The type of surgery depends on the type of hematoma you have. Options include: […] Surgical drainage. If the blood is in one area and has changed from a solid clot to a liquid, your doctor might create a small hole in your skull and use suction to remove the liquid. […] Removing part of the skull, known as a craniotomy. Large hematomas might require that a section of your skull be opened to remove the blood.

• #24 Intracranial Hemorrhage Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1163977-treatment

  Early treatment in patients presenting with spontaneous intracerebral hemorrhage is important as it may decrease hematoma enlargement and lead to better neurologic outcome. […] Initiate fosphenytoin or other anticonvulsant definitely for seizure activity or lobar hemorrhage, and optionally in other patients. Levetiracetam has shown efficacy in children for prophylaxis of early posthemorrhagic seizures. […] While reducing SBP with intravenous nicardipine hydrochloride does not significantly reduce hematoma expansion in patients with ICH, the Antihypertensive Treatment of Acute Cerebral Hemorrhage study supports further studies to evaluate the efficacy of aggressive pharmacologic SBP reduction. […] Consider surgery for patients with cerebellar hemorrhage greater than 3 cm, for patients with intracerebral hemorrhage associated with a structural vascular lesion, and for young patients with lobar hemorrhage. […] Surgical approaches include the following: Craniotomy and clot evacuation under direct visual guidance, Stereotactic aspiration with thrombolytic agents, Endoscopic evacuation.

• #25 Surgery for Intracerebral Hemorrhage | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/intracerebral-hemorrhage/surgery-intracerebral-hemorrhage

  An intracerebral hemorrhage (hemorrhagic stroke) is an extreme medical emergency that requires immediate treatment. A neurosurgeon with advanced training and years of experience with acute stroke and other cerebrovascular conditions will evaluate a patient to determine whether surgery is the best course of treatment. […] DECOMPRESSION SURGERY relieves pressure on the brain and allows a skilled neurosurgeon to remove the pooled blood and repair damaged blood vessels. Evacuating (draining) the hematoma immediately relieves pressure on the brain by reducing the size of the pooled blood from the bleed, thereby reducing secondary damage to the brain resulting from increased intracranial pressure. A skilled neurosurgeon may choose from different surgical methods to evacuate the hematoma: […] Craniotomy with open surgery The neurosurgeon removes a portion of the skull and conducts open surgery to drain the hematoma and repair the ruptured blood vessel. This is a major surgical procedure that is typically used when the hematoma is very large, or when its compressing the brain stem, where critical functions are controlled.

• #26 Intracranial hematoma | Altru Health System

  https://www.altru.org/health-library/conditions/intracranial-hematoma

  Intracranial hematomas that are small and produce no symptoms don’t need to be removed. However, symptoms can appear or worsen days or weeks after the injury. As a result, you might have to be watched for neurological changes, have your intracranial pressure monitored and undergo repeated head CT scans. […] If you take blood-thinning medicine, such as warfarin (Jantoven), you may need therapy to reverse the effects of the medicine. This will reduce the risk of further bleeding. Options for reversing blood thinners include giving vitamin K and fresh frozen plasma. […] Intracranial hematoma treatment often involves surgery. The type of surgery depends on the type of hematoma you have. Options include: […] Surgical drainage. If the blood is in one area and has changed from a solid clot to a liquid, your doctor might create a small hole in your skull and use suction to remove the liquid. […] Removing part of the skull, known as a craniotomy. Large hematomas might require that a section of your skull be opened to remove the blood.

• #27 Surgery for Intracerebral Hemorrhage | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/intracerebral-hemorrhage/surgery-intracerebral-hemorrhage

  Small craniotomy with evacuation Recent studies suggest that performing a small craniotomy (opening a bone window in the skull that’s smaller than what is typically done in a craniotomy) and using a small tube inserted into the blood clot, through which the blood clot can be aspirated, can be very effective. […] Simple aspiration The surgeon drills a small hole (a burr hole) in the skull and drains the hematoma using a small rubber tube or catheter. This is a relatively noninvasive procedure, but it doesn’t always allow the surgeon to drain the hematoma completely. It is rarely performed. […] Endoscopic evacuation is a minimally invasive surgical technique to drain a subdural hemorrhage. […] Endoscopic evacuation This is similar to simple aspiration in that it involves drilling a hole in the skull, but instead of traditional surgical instruments a highly skilled neurosurgeon can reach and drain the hematoma using an endoscope (a tiny camera-guided instrument).

• #28 Intracranial hematoma | Altru Health System

  https://www.altru.org/health-library/conditions/intracranial-hematoma

  Intracranial hematomas that are small and produce no symptoms don’t need to be removed. However, symptoms can appear or worsen days or weeks after the injury. As a result, you might have to be watched for neurological changes, have your intracranial pressure monitored and undergo repeated head CT scans. […] If you take blood-thinning medicine, such as warfarin (Jantoven), you may need therapy to reverse the effects of the medicine. This will reduce the risk of further bleeding. Options for reversing blood thinners include giving vitamin K and fresh frozen plasma. […] Intracranial hematoma treatment often involves surgery. The type of surgery depends on the type of hematoma you have. Options include: […] Surgical drainage. If the blood is in one area and has changed from a solid clot to a liquid, your doctor might create a small hole in your skull and use suction to remove the liquid. […] Removing part of the skull, known as a craniotomy. Large hematomas might require that a section of your skull be opened to remove the blood.

• #29

  https://www.nhs.uk/conditions/subdural-haematoma/treatment/

  Surgery is recommended for most subdural haematomas. Very small subdural haematomas may be carefully monitored first to see if they heal without having an operation. […] If surgery is recommended, it’ll be carried out by a neurosurgeon (an expert in surgery of the brain and nervous system). […] There are 2 widely used surgical techniques to treat subdural haematomas: craniotomy a section of the skull is temporarily removed so the surgeon can access and remove the haematoma; burr holes a small hole is drilled into the skull and a tube is inserted through the hole to help drain the haematoma. […] A craniotomy is the main treatment for subdural haematomas that develop soon after a severe head injury (acute subdural haematomas). […] Burr hole surgery is the main treatment for subdural haematomas that develop a few days or weeks after a minor head injury (chronic subdural haematomas).

• #30 Surgery for Intracerebral Hemorrhage | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/intracerebral-hemorrhage/surgery-intracerebral-hemorrhage

  An intracerebral hemorrhage (hemorrhagic stroke) is an extreme medical emergency that requires immediate treatment. A neurosurgeon with advanced training and years of experience with acute stroke and other cerebrovascular conditions will evaluate a patient to determine whether surgery is the best course of treatment. […] DECOMPRESSION SURGERY relieves pressure on the brain and allows a skilled neurosurgeon to remove the pooled blood and repair damaged blood vessels. Evacuating (draining) the hematoma immediately relieves pressure on the brain by reducing the size of the pooled blood from the bleed, thereby reducing secondary damage to the brain resulting from increased intracranial pressure. A skilled neurosurgeon may choose from different surgical methods to evacuate the hematoma: […] Craniotomy with open surgery The neurosurgeon removes a portion of the skull and conducts open surgery to drain the hematoma and repair the ruptured blood vessel. This is a major surgical procedure that is typically used when the hematoma is very large, or when its compressing the brain stem, where critical functions are controlled.

• #31 Surgery for Intracerebral Hemorrhage | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/intracerebral-hemorrhage/surgery-intracerebral-hemorrhage

  Small craniotomy with evacuation Recent studies suggest that performing a small craniotomy (opening a bone window in the skull that’s smaller than what is typically done in a craniotomy) and using a small tube inserted into the blood clot, through which the blood clot can be aspirated, can be very effective. […] Simple aspiration The surgeon drills a small hole (a burr hole) in the skull and drains the hematoma using a small rubber tube or catheter. This is a relatively noninvasive procedure, but it doesn’t always allow the surgeon to drain the hematoma completely. It is rarely performed. […] Endoscopic evacuation is a minimally invasive surgical technique to drain a subdural hemorrhage. […] Endoscopic evacuation This is similar to simple aspiration in that it involves drilling a hole in the skull, but instead of traditional surgical instruments a highly skilled neurosurgeon can reach and drain the hematoma using an endoscope (a tiny camera-guided instrument).

• #32

  https://www.nhs.uk/conditions/subdural-haematoma/treatment/

  Surgery is recommended for most subdural haematomas. Very small subdural haematomas may be carefully monitored first to see if they heal without having an operation. […] If surgery is recommended, it’ll be carried out by a neurosurgeon (an expert in surgery of the brain and nervous system). […] There are 2 widely used surgical techniques to treat subdural haematomas: craniotomy a section of the skull is temporarily removed so the surgeon can access and remove the haematoma; burr holes a small hole is drilled into the skull and a tube is inserted through the hole to help drain the haematoma. […] A craniotomy is the main treatment for subdural haematomas that develop soon after a severe head injury (acute subdural haematomas). […] Burr hole surgery is the main treatment for subdural haematomas that develop a few days or weeks after a minor head injury (chronic subdural haematomas).

• #33 Subdural Hematoma: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21183-subdural-hematoma

  Subdural hematomas can be life-threatening and need immediate medical care. […] For large or severe subdural hematomas, you usually need surgery. There are two main types: […] Craniotomy: A neurosurgeon temporarily removes a section of your skull so they can access and remove the hematoma. This is the main treatment for acute subdural hematomas. […] Burr holes: A neurosurgeon drills one or more small holes into your skull. They insert a tube through the hole to help drain the blood. They typically leave a drain in place for several days following surgery to allow the blood to continue draining. This is the main treatment for chronic subdural hematomas. […] Sometimes, hematomas cause few or no symptoms and are small enough that they don’t require surgical treatment. Rest, medications and observation may be all that you need. Your healthcare provider may order regular imaging tests (such as an MRI) to monitor the hematoma and make sure it’s healing.

• #34 Surgery for Intracerebral Hemorrhage | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/intracerebral-hemorrhage/surgery-intracerebral-hemorrhage

  Small craniotomy with evacuation Recent studies suggest that performing a small craniotomy (opening a bone window in the skull that’s smaller than what is typically done in a craniotomy) and using a small tube inserted into the blood clot, through which the blood clot can be aspirated, can be very effective. […] Simple aspiration The surgeon drills a small hole (a burr hole) in the skull and drains the hematoma using a small rubber tube or catheter. This is a relatively noninvasive procedure, but it doesn’t always allow the surgeon to drain the hematoma completely. It is rarely performed. […] Endoscopic evacuation is a minimally invasive surgical technique to drain a subdural hemorrhage. […] Endoscopic evacuation This is similar to simple aspiration in that it involves drilling a hole in the skull, but instead of traditional surgical instruments a highly skilled neurosurgeon can reach and drain the hematoma using an endoscope (a tiny camera-guided instrument).

• #35 Surgery for Intracerebral Hemorrhage | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/intracerebral-hemorrhage/surgery-intracerebral-hemorrhage

  Stereotactic aspiration uses computed tomography (CT) to locate the hematoma and a specially developed suction tool to drain it. The patient is immobilized in a stereotactic head frame that allows a greater degree of precision and accuracy than otherwise possible. […] Clipping or coiling procedures may be appropriate if the intracerebral hemorrhage is caused by a ruptured aneurysm or AVM. In these situations multiple interventions are often required and include decompression surgery as well.

• #36 Intracranial Hemorrhage Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1163977-treatment

  Early treatment in patients presenting with spontaneous intracerebral hemorrhage is important as it may decrease hematoma enlargement and lead to better neurologic outcome. […] Initiate fosphenytoin or other anticonvulsant definitely for seizure activity or lobar hemorrhage, and optionally in other patients. Levetiracetam has shown efficacy in children for prophylaxis of early posthemorrhagic seizures. […] While reducing SBP with intravenous nicardipine hydrochloride does not significantly reduce hematoma expansion in patients with ICH, the Antihypertensive Treatment of Acute Cerebral Hemorrhage study supports further studies to evaluate the efficacy of aggressive pharmacologic SBP reduction. […] Consider surgery for patients with cerebellar hemorrhage greater than 3 cm, for patients with intracerebral hemorrhage associated with a structural vascular lesion, and for young patients with lobar hemorrhage. […] Surgical approaches include the following: Craniotomy and clot evacuation under direct visual guidance, Stereotactic aspiration with thrombolytic agents, Endoscopic evacuation.

• #37 Surgery for Intracerebral Hemorrhage | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/intracerebral-hemorrhage/surgery-intracerebral-hemorrhage

  Stereotactic aspiration uses computed tomography (CT) to locate the hematoma and a specially developed suction tool to drain it. The patient is immobilized in a stereotactic head frame that allows a greater degree of precision and accuracy than otherwise possible. […] Clipping or coiling procedures may be appropriate if the intracerebral hemorrhage is caused by a ruptured aneurysm or AVM. In these situations multiple interventions are often required and include decompression surgery as well.

• #38 Treating Subdural Hematoma Symptoms | University of Utah Health

  https://healthcare.utah.edu/neurosciences/neurosurgery/subdural-hematoma

  We may need to treat some chronic subdural hematomas with brain surgery to drain the blood that has collected between the brain and the dura (outermost covering of the brain). […] MMA embolization is a minimally invasive, non-surgical procedure that takes place in our state-of-the-art Neurointerventional Radiology Suite. […] As a non-surgical alternative, undergoing MMA embolization includes shorter hospital stays and a faster recovery. This is commonly used as a stand-alone treatment for a patient with a chronic subdural hematoma. In some cases, your neurosurgeon may recommend MMA embolization as a follow-up therapy if initial brain surgery for the chronic subdural hematoma was not successful. This has been shown to decrease the risk of a recurring hematoma and decrease the chances of needing another operation to re-drain it.

• #39 Treating Subdural Hematoma Symptoms | University of Utah Health

  https://healthcare.utah.edu/neurosciences/neurosurgery/subdural-hematoma

  We may need to treat some chronic subdural hematomas with brain surgery to drain the blood that has collected between the brain and the dura (outermost covering of the brain). […] MMA embolization is a minimally invasive, non-surgical procedure that takes place in our state-of-the-art Neurointerventional Radiology Suite. […] As a non-surgical alternative, undergoing MMA embolization includes shorter hospital stays and a faster recovery. This is commonly used as a stand-alone treatment for a patient with a chronic subdural hematoma. In some cases, your neurosurgeon may recommend MMA embolization as a follow-up therapy if initial brain surgery for the chronic subdural hematoma was not successful. This has been shown to decrease the risk of a recurring hematoma and decrease the chances of needing another operation to re-drain it.

• #40 New avenues for treatment of intracranial hemorrhage

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3932437/

  The mortality and morbidity from intracerebral hemorrhage (ICH) remain high despite advances in medical, neurological, and surgical care during the past decade. […] 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. […] The mechanisms of neurologic injury in ICH outlined above offer numerous potential therapeutic targets, which can be summarized as follows: 1- Reducing the size of the hematoma through surgical evacuation, or minimally invasive stereotactic aspiration. 2- Limiting hematoma expansion, either through the use of hemostatic agents, reversal of coagulopathy, or intensive blood pressure (BP) lowering. 3- Modifying the molecular events precipitating the secondary effects of ICH, in particular iron-mediated toxicity, and inflammation induced by hemoglobin degradation products, or accelerating endogenous hematoma resolution.

• #41 The clinical effect of minimally invasive stereotactic puncture intracranial hematoma removal in the treatment of patients with cerebral hemorrhage: a meta-analysis

  https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2444-054X2023000600762

  The clinical effect of minimally invasive stereotactic puncture intracranial hematoma removal in the treatment of patients with cerebral hemorrhage: a meta-analysis […] The objective of the study was to systemically evaluate the clinical efficacy of minimally invasive stereotactic puncture for intracranial hematoma evacuation in patients with cerebral hemorrhage. […] The results of the meta-analysis showed that, compared with traditional craniotomy or treatment, minimally invasive stereotactic puncture intracranial hematoma removal had a higher clinical total effective rate in patients with cerebral hemorrhage, an outcome that could significantly shorten the hospitalization time of patients with cerebral hemorrhage. […] Compared with traditional craniotomy or conservative treatment, minimally invasive stereotactic puncture intracranial hematoma removal has a higher clinical efficacy in the treatment of patients with cerebral hemorrhage, which can improve the post-operative daily life and abilities of patients.

• #42 The clinical effect of minimally invasive stereotactic puncture intracranial hematoma removal in the treatment of patients with cerebral hemorrhage: a meta-analysis

  https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2444-054X2023000600762

  The clinical effect of minimally invasive stereotactic puncture intracranial hematoma removal in the treatment of patients with cerebral hemorrhage: a meta-analysis […] The objective of the study was to systemically evaluate the clinical efficacy of minimally invasive stereotactic puncture for intracranial hematoma evacuation in patients with cerebral hemorrhage. […] The results of the meta-analysis showed that, compared with traditional craniotomy or treatment, minimally invasive stereotactic puncture intracranial hematoma removal had a higher clinical total effective rate in patients with cerebral hemorrhage, an outcome that could significantly shorten the hospitalization time of patients with cerebral hemorrhage. […] Compared with traditional craniotomy or conservative treatment, minimally invasive stereotactic puncture intracranial hematoma removal has a higher clinical efficacy in the treatment of patients with cerebral hemorrhage, which can improve the post-operative daily life and abilities of patients.

• #43 The clinical effect of minimally invasive stereotactic puncture intracranial hematoma removal in the treatment of patients with cerebral hemorrhage: a meta-analysis

  https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2444-054X2023000600762

  Minimally invasive stereotactic puncture evacuation of intracranial hematoma has a higher clinical efficacy. […] Minimally invasive stereotactic puncture evacuation of intracranial hematoma can effectively reduce iatrogenic blood loss in patients with cerebral hemorrhage, quickly puncture the hematoma, aspirate the fluid part of cerebral hemorrhage and reduce intracranial pressure in a very short time. […] Minimally invasive stereotactic puncture evacuation of intracranial hematoma has little effect on postoperative activities of daily life in patients with cerebral hemorrhage. […] The results of this study showed that patients treated with minimally invasive stereotactic puncture evacuation of intracranial hematoma had a lower incidence of postoperative complications and a lower mortality rate compared with patients in the control group.

• #44 A new surgical method of treatment spontaneous intracranial hemorrhage

  https://www.degruyter.com/document/doi/10.1515/tnsci-2020-0164/html?lang=en

  This study aimed to determine the safety and effectiveness of DTI-assisted neuroendoscopy for treating intracranial hemorrhage (ICH). […] The prognostic modified Rankin Scale (mRS) score was significantly better (P = 0.027) in the DTI-assisted neuroendoscopy group than in the standard neuroendoscopy group. […] The use of DTI in neuroendoscopic hematoma removal can significantly improve neurological function outcomes in patients, but it does not significantly affect the mortality of patients. […] The treatment methods for ICH remain controversial. […] The advantages of minimally invasive surgery when removing a hematoma are not only that the intervention is less traumatic, but also that it can effectively relieve the pressure exerted by the hematoma on normal brain tissue, as well as reducing secondary damage to brain tissue due to factors such as harmful substances, cytotoxins, and free radicals in the blood.

• #45 A new surgical method of treatment spontaneous intracranial hemorrhage

  https://www.degruyter.com/document/doi/10.1515/tnsci-2020-0164/html?lang=en

  Therefore, DTI-assisted neuroendoscopy may be able to reduce iatrogenic damage to the white matter during surgery and so improve the neurological function outcomes of the patients. […] In summary, we believe that neuroendoscopy supplemented with DTI for the treatment of ICH (when conditions permit) is an effective way to reduce the disability rate of patients and improve their neurological function outcomes.

• #46 Explore Non-Surgical Treatment for Intracranial Hemorrhage (Brain Bleed)

  https://www.vejthani.com/2024/11/explore-non-surgical-treatment-for-intracranial-hemorrhage-brain-bleed/

  Accidents can happen to anyone, anywhere, but older adults need to be especially cautious about even minor head impacts, as these can lead to intracranial hemorrhage, which is characterized by bleeding within the brain. The conventional approach for treating intracranial hemorrhage involves open brain surgery to remove accumulated blood, reducing brain pressure and preventing further brain damage. […] However, advancements in technology can help treat intracranial hemorrhage with a non-surgical method. Catheter insertion and Endovascular Embolization are done to stop brain bleeding. This procedure not only prevents the need for surgery but also eliminates the requirement for general anesthesia, reducing the risk of complications and infection. Moreover, the recovery time is reduced, often requiring just a one-night hospital stay.

• #47 Intracranial Hematoma Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/intracranial-hematoma

  An intracranial hematoma is a collection of clotted blood that forms inside the skull after an injury. At Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, our neurosurgeons specialize in treating intracranial hematoma. Standard treatment may include expert monitoring and/or surgery for drainage. […] Treatment is individualized, depending on the extent of the hematoma and the presence of other injuries. Depending on the severity of the injury, management may include: Stitches, Hospitalization for observation, Surgery to drain blood and remove the blood clot. […] A patient who has a severe head injury may require monitoring to manage increased intracranial pressure (ICP). […] If the pressure goes up, doctors can administer immediate treatmentmedical, surgical, or both.

• #48 1. Emergency Management of Intracerebral Hemorrhage | Canadian Stroke Best Practices

  https://www.strokebestpractices.ca/recommendations/management-of-intracerebral-hemorrhage/emergency-management-of-intracerebral-hemorrhage

  External ventricular drainage (EVD) should be considered in patients with a reduced level of consciousness and hydrocephalus due to either intraventricular hemorrhage or mass effect [Evidence Level B]. […] Surgical evacuation is not recommended if symptoms are stable and there are no signs of herniation [Evidence Level B]. […] Acute surgical intervention may be considered in patients with surgically accessible supratentorial hemorrhages and clinical signs of herniation (e.g., decreasing levels of consciousness (LOC), pupillary changes) [Evidence Level C]. […] The clinical benefit of minimally invasive clot evacuation is yet to be established. […] Confirmation of anticoagulation reversal should be obtained intraoperatively.

• #49 Spontaneous intracerebral hemorrhage: Acute treatment and prognosis – UpToDate

  https://www.uptodate.com/contents/spontaneous-intracerebral-hemorrhage-acute-treatment-and-prognosis

  Intracranial pressure management […] Identifying patients with an indication for emergent surgery […] Preventive measures for all other patients […] Assessing elevated ICP […] Clinical examination findings […] Invasive ICP monitoring when clinical exam is unreliable […] Serial imaging for other patients […] Treatment measures for patients who have severe or progressive ICP elevation […] Osmotic therapy […] Surgical approaches for selected patients […] Cerebrospinal fluid drainage for obstructive hydrocephalus […] Surgical decompression […] Cerebellar hemorrhage […] Supratentorial hemorrhage […] […] […] Salvage therapies

• #50 Spontaneous intracerebral hemorrhage: Acute treatment and prognosis – UpToDate

  https://www.uptodate.com/contents/spontaneous-intracerebral-hemorrhage-acute-treatment-and-prognosis

  Intracranial pressure management […] Identifying patients with an indication for emergent surgery […] Preventive measures for all other patients […] Assessing elevated ICP […] Clinical examination findings […] Invasive ICP monitoring when clinical exam is unreliable […] Serial imaging for other patients […] Treatment measures for patients who have severe or progressive ICP elevation […] Osmotic therapy […] Surgical approaches for selected patients […] Cerebrospinal fluid drainage for obstructive hydrocephalus […] Surgical decompression […] Cerebellar hemorrhage […] Supratentorial hemorrhage […] […] […] Salvage therapies

• #51 Intracranial Hemorrhage Medication: Antihypertensive agents, Osmotic diuretics, Antipyretics, analgesics, Anticonvulsants, Antidotes, Antacids

  https://emedicine.medscape.com/article/1163977-medication

  Antihypertensive agents reduce blood pressure to prevent exacerbation of intracerebral hemorrhage. Osmotic diuretics, such as mannitol, may be used to decrease intracranial pressure. […] As hyperthermia may exacerbate neurological injury, acetaminophen may be given to reduce fever and to relieve headache. […] Anticonvulsants are used routinely to avoid seizures that may be induced by cortical damage. Levetiracetam has shown efficacy in children for prophylaxis of early posthemorrhagic seizures. […] Additional data suggest that levetiracetam is more effective than phenytoin for seizure prophylaxis without suppression of cognitive abilities in patients with ICH. […] Vitamin K and protamine may be used to restore normal coagulation parameters. Antacids are used to prevent gastric ulcers associated with intracerebral hemorrhage.

• #52

  https://www.aurorahealthcare.org/services/neuroscience/brain-skull-base-care/brain-hemorrhage

  Treatments depend on the size of the bleed, the location in the brain and the amount of swelling. Getting prompt treatment improves the chances of recovery. […] Brain hemorrhage treatments may include: […] Surgery: In some cases, traditional surgery may be needed to drain blood from the brain or to repair damaged blood vessels. […] Draining the fluid that surrounds the brain: This creates room for the hematoma to expand without damaging brain cells. […] Medication: Drugs are used to control blood pressure, seizures or headaches. […] Catheter: A long, thin tube is threaded through blood vessels until it reaches the affected area.

• #53 Spontaneous intracerebral hemorrhage: Acute treatment and prognosis – UpToDate

  https://www.uptodate.com/contents/spontaneous-intracerebral-hemorrhage-acute-treatment-and-prognosis

  Intracranial pressure management […] Identifying patients with an indication for emergent surgery […] Preventive measures for all other patients […] Assessing elevated ICP […] Clinical examination findings […] Invasive ICP monitoring when clinical exam is unreliable […] Serial imaging for other patients […] Treatment measures for patients who have severe or progressive ICP elevation […] Osmotic therapy […] Surgical approaches for selected patients […] Cerebrospinal fluid drainage for obstructive hydrocephalus […] Surgical decompression […] Cerebellar hemorrhage […] Supratentorial hemorrhage […] […] […] Salvage therapies

• #54 Brain Bleed (Intracranial Hemorrhage): Causes & Symptoms

  https://my.clevelandclinic.org/health/diseases/14480-brain-bleed-hemorrhage-intracranial-hemorrhage

  Based on your diagnostic test results, a healthcare provider may prescribe the following medications to treat the symptoms, the underlying cause or prevent complications of a brain bleed: Anti-anxiety medications. Antiseizure medications. Blood pressure management medications. Pain relievers. Steroid medications (corticosteroids). Stool softeners (to prevent straining and pressure). […] You may need rehabilitation after a brain bleed. Depending on the severity of the bleed, brain damage is a possibility that can affect your ability to complete your daily routine. Rehabilitation can help you regain the functions needed for daily living and prevent future brain bleeds.

• #55 Brain hemorrhage: Causes, symptoms, and treatments

  https://www.medicalnewstoday.com/articles/317080

  Surgery may be necessary to treat a severe brain hemorrhage. Surgeons may operate to relieve some of the pressure on the brain. […] If a burst cerebral aneurysm causes a hemorrhage, a healthcare professional may recommend cerebral angiography with imaging assistance, which is a minimally invasive procedure. In some cases, a surgeon may remove part of the skull and clip the artery. This procedure is called a craniotomy. […] Other treatment options include anxiety drugs, antiseizure drugs, and other medications to control symptoms, such as seizures and severe headaches. […] People can recover from a brain hemorrhage, although it is vital that they receive the correct treatment as soon as possible. Rehabilitation can help an individual adjust to life after a brain hemorrhage. […] Rehabilitation treatment includes: physical therapy, speech therapy, occupational therapy, lifestyle changes to limit the risk of another hemorrhage.

• #56 Subdural Hematoma: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21183-subdural-hematoma

  Like all surgeries, craniotomies and burr hole surgeries carry a risk of complications. Most of these complications are uncommon, but they can be serious. […] The length of time it takes to recover from a subdural hematoma varies from person to person. Your healthcare provider can tell you what to expect based on your unique situation. Some people feel better a few weeks after treatment, while others may never make a full recovery. […] If you have persistent symptoms after surgery like memory problems or weakness, you may need further treatment to help you gradually return to your normal activities.

• #57 Subdural Hematoma: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21183-subdural-hematoma

  Like all surgeries, craniotomies and burr hole surgeries carry a risk of complications. Most of these complications are uncommon, but they can be serious. […] The length of time it takes to recover from a subdural hematoma varies from person to person. Your healthcare provider can tell you what to expect based on your unique situation. Some people feel better a few weeks after treatment, while others may never make a full recovery. […] If you have persistent symptoms after surgery like memory problems or weakness, you may need further treatment to help you gradually return to your normal activities.

• #58

  https://www.nhs.uk/conditions/subdural-haematoma/treatment/

  Like all operations, surgery for a subdural haematoma carries a risk of complications. […] If surgery goes well and you do not have any complications, you may be well enough to leave hospital after a few days. […] If you have persistent problems after surgery, such as memory problems or weakness in your limbs, you may need further treatment to help you gradually return to your normal activities.

• #59 Intracranial Hematomas – Injuries and Poisoning – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/injuries-and-poisoning/head-injuries/intracranial-hematomas

  About half of people who are treated for a large acute subdural hematoma survive. People who are treated for a chronic subdural hematoma usually improve or do not worsen. […] Surgery is usually avoided because of the following: Intracerebral hematomas are caused by direct damage to the brain. Usually, surgery does not restore brain function. Hematomas are within the brain tissue. Thus, doctors must remove the overlying brain to get at the hematoma. Removing this tissue contributes to loss of brain function.

• #60 Intracranial Hematomas – Injuries and Poisoning – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/injuries-and-poisoning/head-injuries/intracranial-hematomas

  About half of people who are treated for a large acute subdural hematoma survive. People who are treated for a chronic subdural hematoma usually improve or do not worsen. […] Surgery is usually avoided because of the following: Intracerebral hematomas are caused by direct damage to the brain. Usually, surgery does not restore brain function. Hematomas are within the brain tissue. Thus, doctors must remove the overlying brain to get at the hematoma. Removing this tissue contributes to loss of brain function.

• #61 Treating Subdural Hematoma Symptoms | University of Utah Health

  https://healthcare.utah.edu/neurosciences/neurosurgery/subdural-hematoma

  With effective treatment, the vast majority of chronic subdural hematomas will go away for patients. Many patients will also notice a reduction in symptoms such as decreased headaches, improved walking, and more energy. After the initial treatment, your neurosurgeon will conduct follow-up testing. If the hematoma returns or remains in your brain, your doctor will discuss additional treatment options and next steps with you.

• #62 New avenues for treatment of intracranial hemorrhage

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3932437/

  The mortality and morbidity from intracerebral hemorrhage (ICH) remain high despite advances in medical, neurological, and surgical care during the past decade. […] 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. […] The mechanisms of neurologic injury in ICH outlined above offer numerous potential therapeutic targets, which can be summarized as follows: 1- Reducing the size of the hematoma through surgical evacuation, or minimally invasive stereotactic aspiration. 2- Limiting hematoma expansion, either through the use of hemostatic agents, reversal of coagulopathy, or intensive blood pressure (BP) lowering. 3- Modifying the molecular events precipitating the secondary effects of ICH, in particular iron-mediated toxicity, and inflammation induced by hemoglobin degradation products, or accelerating endogenous hematoma resolution.

• #63 New avenues for treatment of intracranial hemorrhage

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3932437/

  Given the neutral effects of craniotomy and hematoma evacuation and the inherent risks of a surgical approach, especially for hemorrhages with a deep parenchymal location, minimally invasive methods are now the subject of vigorous investigations. […] Overall, there is guarded optimism that minimally invasive aspiration of the clot with local t-PA alone or in combination with ultrasound could provide a successful strategy to treat ICH in the future if the results of planned phase III trials support its safety and efficacy. […] Hematoma expansion (HE) remains a major target to minimize neurological deterioration and decrease morbidity and mortality after ICH. […] The Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage (INTERACT) and the Antihypertensive Treatment in Acute Cerebral Hemorrhage (ATACH) trials showed that early intensive systolic blood pressure lowering to less than 140 mm Hg is clinically feasible, well tolerated, and seems to reduce HE in ICH.

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