Title :

Indications for surgical evacuation of cerebellar intracerebral hemorrhage: consensus guidelines from the French Society of Neurosurgery (SFNC) and the French Society of Vascular Neurology (SFNV)

Author(s) :

Metayer, Thomas [Auteur]
Service de Neurochirurgie [CHU Caen]
Institut Blood and Brain @ Caen-Normandie [Caen] [BB@C]
Pasi, Marco [Auteur]
Centre Hospitalier Régional Universitaire de Tours [CHRU Tours]
Magro, Elsa [Auteur]
Service de neurochirurgie [Brest]
Lejeune, Jean Paul [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Thines, Laurent [Auteur]
Centre Hospitalier Régional Universitaire de Besançon [CHRU Besançon]
Sibon, Igor [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Touze, Emmanuel [Auteur]
Service de Neurologie [CHU Caen]
Université de Caen Normandie [UNICAEN]
Cordonnier, Charlotte [Auteur]
Département de neurologie [Lille]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Gaberel, Thomas [Auteur]
Service de Neurochirurgie [CHU Caen]
Institut Blood and Brain @ Caen-Normandie [Caen] [BB@C]

Journal title :

Neurochirurgie

Volume number :

70

Pages :

101506

Publisher :

Elsevier Masson

Publication date :

2023-11-04

ISSN :

1773-0619

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background Cerebellar intracerebral hemorrhage (ICH) is associated with poor functional prognosis and high mortality. Surgical evacuation has been proposed to improve outcome. The purpose of this review was to determine ...
Show more >Background Cerebellar intracerebral hemorrhage (ICH) is associated with poor functional prognosis and high mortality. Surgical evacuation has been proposed to improve outcome. The purpose of this review was to determine the benefit of surgical evacuation of cerebellar ICH and to establish guidelines for when it should be performed. Method The writing committee comprised 9 members of the SFNV and the SFNC. Recommendations were established based on a literature review using the PICO questions. The American Heart Association (AHA) classification was used to define recommendation level. In case of insufficient evidence, expert opinions were provided. Results Levels of evidence were low to moderate, precluding definitive recommendations. Based on available data, surgical hematoma evacuation is not recommended to improve functional outcome (Class III; Level B NR). However, based on subgroup analysis, surgical evacuation may be considered in strictly selected patients (Class IIb; Level C-EO): hematoma volume 15−25 cm3, GCS 6-10, and no oral anticoagulation or antiplatelet therapy. Moreover, surgical evacuation is recommended to decrease risk of death (Class IIa; Level B NR) in patients with a hematoma volume >15 cm3 and GCS score <10. Conclusion These guidelines were based on observational studies, limiting the level of evidence. However, except for strictly selected patients, surgical evacuation of cerebellar ICH was not associated with improved functional outcome, limiting indications. Data from RCTs are needed in this field.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Lille Neurosciences & Cognition (LilNCog) - U 1172

Research team(s) :

Troubles cognitifs dégénératifs et vasculaires

Submission date :

2024-01-15T22:11:13Z
2024-12-06T15:40:34Z