Download PDF
J Neurol Surg A Cent Eur Neurosurg 2023; 84(04): 377-385
DOI: 10.1055/s-0041-1741530
Review Article

Therapeutic Strategies in Traumatic Intracranial Hemorrhage and Outcomes

Amanjung Singh
1   Division of Trauma, Jersey Shore University Medical Center, Neptune, New Jersey, United States
,
Radhika Trivedi 
1   Division of Trauma, Jersey Shore University Medical Center, Neptune, New Jersey, United States
,
Nasim Ahmed
2   Division of Trauma and Surgical Critical Care, Jersey Shore University Medical Center, Neptune, New Jersey, United States
3   Hackensack Meridian School of Medicine, Nutley, New Jersey, United States
› Author Affiliations Funding None.
› Further Information
Also available at
   Permissions and Reprints
Zoom Image

Abstract

Background Traumatic intracranial hemorrhage (TICH) and its progression have historically resulted in poor prognosis and functional disability. Such outcomes can impact the daily lives and financial condition of patients' families as well as add burden to the health care system. This review examines the diverse therapeutic intervention that were observed in randomized clinical trials (RCT) on various outcomes. Many demographic and clinical risk factors have been identified for poor prognosis after a TICH. Among the many therapeutic strategies studied, few found to have some beneficial effect in minimizing the progression of hemorrhage and reducing the overall mortality.

Methods A literature review was conducted of all relevant sources using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to include articles that were RCTs for patients aged 18 years and above to include a total of 19 articles.

Results Across studies, many therapies have been assessed; however, only few findings including infusion of tranexamic acid (TXA), use of β-blocker, and early operative evacuation of TICH yielded favorable results. Use of steroid and blood transfusion to target higher hemoglobin levels showed evidence of adversely impacting the outcome.

Conclusion Of the many therapeutic strategies available for TICH, very few therapies have proven to be beneficial

Keywords

traumatic intracranial hemorrhage - expansion - interventions - outcomes

Availability of Data and Material

Data used in this study were collected from prior studies and are available for use.


Ethics Approval

This study was exempt from requiring ethics approval because this was a review of existing studies and did not involve human or animal participants.


Authors' Contributions

A.S. and R.T. collected and analyzed the resources, and wrote the manuscript. N.A. is the Principal Investigator and corresponding author, and conceived and designed the review, collected and analyzed resources, and wrote the manuscript.




Publication History

Received: 22 June 2021

Accepted: 15 November 2021

Article published online:
14 February 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany