Aktivare vård angelägen vid spontana intracerebrala hematom. Akut handläggning i Västerbotten jämfört med internationella riktlinjer
Engelsk titel: More active treatment is necessary in spontaneous intracerebral hematomas. Acute management in Västerbotten compared with international guidelines
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Författare:
Bergenheim, Tommy
;
Lagerström, Eric
;
Andersson, Mats
Email: tommy.bergenheim@neuro.umu.se
Språk: Swe
Antal referenser: 19
Dokumenttyp:
Artikel
UI-nummer: 13127104
Sammanfattning
In Västerbotten County, a retrospective study of all patients diagnosed with spontaneous intracerebral hematoma during the years 2008 and 2009 was done. 142 patients were found, they were all admitted to one of the three hospitals in the county and 17 (12 %) were further referred to the regional neurosurgical clinic. The care and the referral pattern were analysed and discussed in relation to the guidelines of the American Heart Association/American Stroke Association as published in Stroke 2010. Differences between the guidelines and the practical management were found. The major discrepancy was regarding the level of care. The guidelines recommend that ”Initial monitoring and management of ICH patients should take place in an intensive care unit with physician and nursing neuroscience intensive care expertise that all patients should at least initially be during the first day”. Few of the patients were in reality referred to a unit with neuro expertise. Less patients than expected from the literature was diagnosed with rebleeding or developed hydrocephalus. This may question the level of activity in the care of those patients. In a rural areas, such as our county, the detection of ”spot signs” after contrast enhanced CT should be a practical way of selecting patients at risk for rebleeding that could benefit of early referral to a neurointensive unit with access to neurosurgery.