Perihemorrhagic edema in non-traumatic intracerebral hematomas
DOI:
https://doi.org/10.25305/unj.117778Keywords:
brain edema, perihematomal edema, non-traumatic cerebral hemorrhage, treatmentAbstract
This scientific review deals with the issues of etiological, pathophysiological treatment of the peri-hemorragic edema (PHE) in non-traumatic intracerebral hematomas (NICH). In the experimental studies there has been shown the role of hemoglobin and the breakdown products in the PHE formation process associated with oxidative damage to cells, reaction of free radicals, metalloproteinases activation, etc. The review presents the results of the experiment PHE treatment with a new medication of deferoxamine, antioxidant alpha tocopherol and local inhibitor of protease — contrycal. PHE staging: ionic edema; vasogenic edema and delayed vasogenic edema has been presented. The article demonstrates the results of diagnostic radiological methods in clinical settings (CT, perfusion CT, and MRI) and various aspects of PHE: regional cerebral blood flow; time of peak values; correlatons of the iron level in NICH and NICH size; correlations of PHE size and of the nearest functional outcome, etc. The review presents the results of broad spectrum of treatment measures for PHE and NICH: operative techniques (minimally invasive technique are prioritized); drug therapy (osmotic diuretics; deferoxamine; gamma agonists; antioxidant — cytoflavin) as well as prolonged hypothermia (35°C).
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