Biomaterial Database

Treatment of spontaneous intracerebral and intracerebellar hemorrhages. 1993

O Heiskanen

Neurosurgical Department, Helsinki University Central Hospital, Finland.

Most primary intracerebral and intracerebellar hemorrhages are hypertensive, and the most common site is the basal ganglion. In typical basal ganglia hematoma, surgery offers no benefit, and such patients should be treated conservatively. Surgery is not indicated in pontine hematomas either. Cerebellar hematomas may block the circulation of the cerebrospinal fluid and cause an acute life-threatening hydrocephalus; therefore such hematomas should be operated on. Subcortical hematomas, which are usually not associated with hypertension and may be due to tumor or vascular malformation, should as a rule be operated on. Carotid angiography is necessary for most supratentorial hematomas to exclude the presence of aneurysm or arteriovenous malformation. Secondary hematomas from ruptured arterial aneurysm should be operated on as urgently as traumatic intracranial hematomas if the patient's level of consciousness is deteriorating and if there is severe neurological deficit. Hematomas due to arteriovenous malformation must sometimes be evacuated as an emergency measure if the patient is unconscious, and the malformation should be excised if technically possible. The operation should preferably be postponed to the second week after the bleeding if the patient's level of consciousness is not deteriorating, since the malformation is more easily excised after the brain edema has subsided. Hematomas associated with anticoagulant treatment should be evacuated if the hematoma is expansive and if the patient is unconscious or somnolent but the results are not very good. Hematomas of hemophiliacs should be evacuated, and these patients need an appropriate replacement therapy.

UI	MeSH Term	Description	Entries
D006973	Hypertension	Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.	Blood Pressure, High,Blood Pressures, High,High Blood Pressure,High Blood Pressures
D001778	Blood Coagulation Disorders	Hemorrhagic and thrombotic disorders that occur as a consequence of abnormalities in blood coagulation due to a variety of factors such as COAGULATION PROTEIN DISORDERS; BLOOD PLATELET DISORDERS; BLOOD PROTEIN DISORDERS or nutritional conditions.	Coagulation Disorders, Blood,Disorders, Blood Coagulation,Blood Coagulation Disorder,Coagulation Disorder, Blood,Disorder, Blood Coagulation
D002526	Cerebellar Diseases	Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, GAIT ATAXIA, and MUSCLE HYPOTONIA.	Cerebellar Dysfunction,Cerebellum Diseases,Cerebellar Disorders,Cerebellar Syndromes,Cerebellar Disease,Cerebellar Disorder,Cerebellar Dysfunctions,Cerebellar Syndrome,Cerebellum Disease,Disease, Cerebellar,Disease, Cerebellum,Disorder, Cerebellar,Dysfunction, Cerebellar,Syndrome, Cerebellar
D002532	Intracranial Aneurysm	Abnormal outpouching in the wall of intracranial blood vessels. Most common are the saccular (berry) aneurysms located at branch points in CIRCLE OF WILLIS at the base of the brain. Vessel rupture results in SUBARACHNOID HEMORRHAGE or INTRACRANIAL HEMORRHAGES. Giant aneurysms (>2.5 cm in diameter) may compress adjacent structures, including the OCULOMOTOR NERVE. (From Adams et al., Principles of Neurology, 6th ed, p841)	Aneurysm, Cerebral,Aneurysm, Intracranial,Basilar Artery Aneurysm,Berry Aneurysm,Brain Aneurysm,Cerebral Aneurysm,Giant Intracranial Aneurysm,Mycotic Aneurysm, Intracranial,Aneurysm, Anterior Cerebral Artery,Aneurysm, Anterior Communicating Artery,Aneurysm, Basilar Artery,Aneurysm, Middle Cerebral Artery,Aneurysm, Posterior Cerebral Artery,Aneurysm, Posterior Communicating Artery,Anterior Cerebral Artery Aneurysm,Anterior Communicating Artery Aneurysm,Middle Cerebral Artery Aneurysm,Posterior Cerebral Artery Aneurysm,Posterior Communicating Artery Aneurysm,Aneurysm, Berry,Aneurysm, Brain,Aneurysm, Giant Intracranial,Aneurysm, Intracranial Mycotic,Aneurysms, Basilar Artery,Aneurysms, Berry,Aneurysms, Brain,Aneurysms, Cerebral,Aneurysms, Giant Intracranial,Aneurysms, Intracranial,Aneurysms, Intracranial Mycotic,Artery Aneurysm, Basilar,Artery Aneurysms, Basilar,Basilar Artery Aneurysms,Berry Aneurysms,Brain Aneurysms,Cerebral Aneurysms,Giant Intracranial Aneurysms,Intracranial Aneurysm, Giant,Intracranial Aneurysms,Intracranial Aneurysms, Giant,Intracranial Mycotic Aneurysm,Intracranial Mycotic Aneurysms,Mycotic Aneurysms, Intracranial
D002538	Intracranial Arteriovenous Malformations	Congenital vascular anomalies in the brain characterized by direct communication between an artery and a vein without passing through the CAPILLARIES. The locations and size of the shunts determine the symptoms including HEADACHES; SEIZURES; STROKE; INTRACRANIAL HEMORRHAGES; mass effect; and vascular steal effect.	Arteriovenous Malformations, Cerebral,Intracranial Arteriovenous Malformations, Congenital,AVM (Arteriovenous Malformation) Intracranial,Cerebral Arteriovenous Malformations,Congenital Intracranial Arteriovenous Malformations,Intracranial Arteriovenous Malformation, Ruptured,Ruptured Intracranial Arteriovenous Malformation,Arteriovenous Malformation, Cerebral,Arteriovenous Malformation, Intracranial,Arteriovenous Malformations, Intracranial,Cerebral Arteriovenous Malformation,Intracranial Arteriovenous Malformation,Malformation, Cerebral Arteriovenous,Malformation, Intracranial Arteriovenous,Malformations, Cerebral Arteriovenous,Malformations, Intracranial Arteriovenous
D002540	Cerebral Cortex	The thin layer of GRAY MATTER on the surface of the CEREBRAL HEMISPHERES that develops from the TELENCEPHALON and folds into gyri and sulci. It reaches its highest development in humans and is responsible for intellectual faculties and higher mental functions.	Allocortex,Archipallium,Cortex Cerebri,Cortical Plate,Paleocortex,Periallocortex,Allocortices,Archipalliums,Cerebral Cortices,Cortex Cerebrus,Cortex, Cerebral,Cortical Plates,Paleocortices,Periallocortices,Plate, Cortical
D002543	Cerebral Hemorrhage	Bleeding into one or both CEREBRAL HEMISPHERES including the BASAL GANGLIA and the CEREBRAL CORTEX. It is often associated with HYPERTENSION and CRANIOCEREBRAL TRAUMA.	Brain Hemorrhage, Cerebral,Cerebral Parenchymal Hemorrhage,Hemorrhage, Cerebral,Intracerebral Hemorrhage,Hemorrhage, Cerebrum,Brain Hemorrhages, Cerebral,Cerebral Brain Hemorrhage,Cerebral Brain Hemorrhages,Cerebral Hemorrhages,Cerebral Parenchymal Hemorrhages,Cerebrum Hemorrhage,Cerebrum Hemorrhages,Hemorrhage, Cerebral Brain,Hemorrhage, Cerebral Parenchymal,Hemorrhage, Intracerebral,Hemorrhages, Cerebral,Hemorrhages, Cerebral Brain,Hemorrhages, Cerebral Parenchymal,Hemorrhages, Cerebrum,Hemorrhages, Intracerebral,Intracerebral Hemorrhages,Parenchymal Hemorrhage, Cerebral,Parenchymal Hemorrhages, Cerebral
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001479	Basal Ganglia	Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres.	Basal Nuclei,Ganglia, Basal,Basal Nuclear Complex,Ganglion, Basal,Basal Nuclear Complices,Nuclear Complex, Basal,Nuclei, Basal
D012422	Rupture, Spontaneous	Tear or break of an organ, vessel or other soft part of the body, occurring in the absence of external force.	Ruptures, Spontaneous,Spontaneous Rupture,Spontaneous Ruptures