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Hjerneblødning (spontan intracerebral blødning)

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Sist revidert av:
  1. McGurgan IJ, Ziai WC, Werring DJ, Al-Shahi Salman R, Parry-Jones AR. Acute intracerebral haemorrhage: diagnosis and management. Pract Neurol. 2020 Dec 7;21(2):128–36. doi: 10.1136/practneurol-2020-002763. Epub ahead of print. PMID: 33288539. PubMed  
  2. Charidimou A, Gang Q, Werring DJ. Sporadic cerebral amyloid angiopathy revisited: recent insights into pathophysiology and clinical spectrum. J Neurol Neurosurg Psychiatry. 2012; 83:124-37. PMID: 22056963 PubMed  
  3. Hemphill JC 3rd, Greenberg SM, Anderson CS, Becker K, Bendok BR, Cushman M, Fung GL, Goldstein JN, Macdonald RL, Mitchell PH, Scott PA, Selim MH, Woo D; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology.. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.. Stroke 2015; Jul;46(7):: 2032-60. pmid:26022637 PubMed  
  4. Kumar S1, Selim M1, Marchina S2, Caplan LR1.. Transient Neurological Symptoms in Patients With Intracerebral Hemorrhage. JAMA Neurol. 2016. pmid:26747699 PubMed  
  5. Boulouis G, Morotti A, Brouwers HB, Charidimou A, Jessel MJ, Auriel E, Pontes-Neto O, Ayres A, Vashkevich A, Schwab KM, Rosand J, Viswanathan A, Gurol ME, Greenberg SM, Goldstein JN. Noncontrast Computed Tomography Hypodensities Predict Poor Outcome in Intracerebral Hemorrhage Patients. Stroke. 2016 Oct;47(10):2511-6 . pmid:27601380 PubMed  
  6. Morotti A, Arba F, Boulouis G, Charidimou A. Noncontrast CT markers of intracerebral hemorrhage expansion and poor outcome: A meta-analysis. Neurology. 2020 Oct 6;95(14):632-643. PMID: 32847959. PubMed  
  7. Rodriguez-Luna D, Coscojuela P, Rubiera M, Hill MD, Dowlatshahi D, Aviv RI, Silva Y, Dzialowski I, Lum C, Czlonkowska A, Boulanger JM, Kase CS, Gubitz G, Bhatia R, Padma V, Roy J, Tomasello A, Demchuk AM, Molina CA; PREDICT/Sunnybrook ICH CTA Study Group. Ultraearly hematoma growth in active intracerebral hemorrhage. Neurology. 2016 Jul 26;87(4):357-64 . pmid:27343067 PubMed  
  8. Demchuk AM, Dowlatshahi D, Rodriguez-Luna D, Molina CA, Blas YS, Dzialowski I, Kobayashi A, Boulanger JM, Lum C, Gubitz G, Padma V, Roy J, Kase CS, Kosior J, Bhatia R, Tymchuk S, Subramaniam S, Gladstone DJ, Hill MD, Aviv RI; PREDICT/Sunnybrook ICH CTA study group. Prediction of haematoma growth and outcome in patients with intracerebral haemorrhage using the CT-angiography spot sign (PREDICT): a prospective observational study. Lancet Neurol 2012; 11: 307-14. PMID: 22405630 PubMed  
  9. Morotti A, Boulouis G, Romero JM, Brouwers HB, Jessel MJ, Vashkevich A, Schwab K, Afzal MR, Cassarly C, Greenberg SM, Martin RH, Qureshi AI, Rosand J, Goldstein JN; ATACH-II and NETT investigators. Blood pressure reduction and noncontrast CT markers of intracerebral hemorrhage expansion.Neurology. 2017 Aug 8;89(6):548-554. PMID: 28701501 PubMed  
  10. Morgenstern LB, Hemphill JC 3rd, Anderson C, Becker K, Broderick JP, Connolly ES Jr, Greenberg SM, Huang JN, MacDonald RL, Messé SR, Mitchell PH, Selim M, Tamargo RJ; American Heart Association Stroke Council and Council on Cardiovascular Nursing. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2010; 41: 2108-29. Stroke  
  11. Schreuder FH, Sato S, Klijn CJ, Anderson CS. Medical management of intracerebral haemorrhage. J Neurol Neurosurg Psychiatry. 2016 Nov 16 . pmid:27852691 PubMed  
  12. Wang X, Arima H, Al-Shahi Salman R, Woodward M, Heeley E, Stapf C, Lavados PM, Robinson T, Huang Y, Wang J, Delcourt C, Anderson CS. Rapid Blood Pressure Lowering According to Recovery at Different Time Intervals after Acute Intracerebral Hemorrhage: Pooled Analysis of the INTERACT Studies. Cerebrovasc Dis. 2015;39(3-4):242-8. doi: 10.1159/000381107. PMID: . pmid:25823544 PubMed  
  13. Song L, Sandset EC, Arima H, Heeley E, Delcourt C, Chen G, Yang J, Wu G, Wang X, Lavados PM, Huang Y, Stapf C, Wang J, Robinson TG, Chalmers J, Lindley RI, Anderson CS; INTERACT2 Investigators. Early blood pressure lowering in patients with intracerebral haemorrhage and prior use of antithrombotic agents: pooled analysis of the INTERACT studies. J Neurol Neurosurg Psychiatry. 2016 May 13. pii: jnnp-2016-313246 . pmid:27178897 PubMed  
  14. Anderson CS, Heeley E, Huang Y, Wang J, Stapf C, Delcourt C, Lindley R, Robinson T, Lavados P, Neal B, Hata J, Arima H, Parsons M, Li Y, Wang J, Heritier S, Li Q, Woodward M, Simes RJ, Davis SM, Chalmers J; INTERACT2 Investigators. Rapid blood-pressure lowering in patients with acute intracerebral hemorrhage. N Engl J Med. 2013 Jun 20;368(25):2355-65 . pmid:23713578 PubMed  
  15. Qureshi AI, Palesch YY, Barsan WG, Hanley DF, Hsu CY, Martin RL, Moy CS, Silbergleit R, Steiner T, Suarez JI, Toyoda K, Wang Y, Yamamoto H, Yoon BW; ATACH-2 Trial Investigators and the Neurological Emergency Treatment Trials Network. Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage. N Engl J Med. 2016 Sep 15;375(11):1033-43 . pmid:27276234 PubMed  
  16. Divani AA1,2, Liu X3, Di Napoli M4, Lattanzi S5, Ziai W6, James ML7, Jafarli A1, Jafari M1, Saver JL8, Hemphill JC9, Vespa PM8, Mayer SA10, Petersen A3.. Blood Pressure Variability Predicts Poor In-Hospital Outcome in Spontaneous Intracerebral Hemorrhage. Stroke. 2019. pmid:31216966 PubMed  
  17. Buletko AB1, Thacker T1, Cho SM1, Mathew J1, Thompson NR1, Organek N1, Frontera JA1, Uchino K2.. Cerebral ischemia and deterioration with lower blood pressure target in intracerebral hemorrhage. Neurology. 2018. pmid: 30097480 PubMed  
  18. Welte TM, Steidl J, Stritzelberger J, Gollwitzer S, Lang JD, Reindl C, Rampp S, Maslarova A, Brandner S, Hock S, Muehlen I, Doerfler A, Kuramatsu JB, Schwab S, Huttner HB, Sprügel MI, Hamer HM. Surgical hematoma evacuation of cortical intracerebral hemorrhage ≥10 ml reduces risk of subsequent epilepsy by more than 70%: A retrospective monocenter study. Eur J Neurol. 2022 Sep 24. doi: 10.1111/ene.15577. Epub ahead of print. PMID: 36151974. PubMed  
  19. Naff N, Williams MA, Keyl PM, Tuhrim S, Bullock MR, Mayer SA, Coplin W, Narayan R, Haines S, Cruz-Flores S, Zuccarello M, Brock D, Awad I, Ziai WC, Marmarou A, Rhoney D, McBee N, Lane K, Hanley DF Jr. Low-dose recombinant tissue-type plasminogen activator enhances clot resolution in brain hemorrhage: the intraventricular hemorrhage thrombolysis trial. Stroke 2011; 11: 3009-16. PMID:21868730 PubMed  
  20. Steiner T, Poli S, Griebe M, Hüsing J, Hajda J, Freiberger A, Bendszus M, Bösel J, Christensen H, Dohmen C, Hennerici M, Kollmer J, Stetefeld H, Wartenberg KE, Weimar C, Hacke W, Veltkamp R. Fresh frozen plasma versus prothrombin complex concentrate in patients with intracranial haemorrhage related to vitamin K antagonists (INCH): a randomised trial. Lancet Neurol. 2016 May;15(6):566-73 . pmid:27302126 PubMed  
  21. Chai-Adisaksopha C, Hillis C, Siegal DM, Movilla R, Heddle N, Iorio A, Crowther M. Prothrombin complex concentrates versus fresh frozen plasma for warfarin reversal. A systematic review and meta-analysis. Thromb Haemost. 2016 Oct 28;116(5):879-890 . pmid:27488143 PubMed  
  22. Apostolaki-Hansson T, Ullberg T, Pihlsgård M, Norrving B, Petersson J. Reversal Treatment in Oral Anticoagulant-Related Intracerebral Hemorrhage-An Observational Study Based on the Swedish Stroke Register. Front Neurol. 2020 Jul 29;11:760. PMID: 32903832 PubMed  
  23. Ihle-Hansen, Hagberg, Sandseth et al. Reversering av antikoagulerende behandling ved hjerneblødning. Tidsskr Nor Legeforen 2021 doi: 10.4045/tidsskr.21.0063 DOI  
  24. Salvesen R, Ingebrigtsen T. Spontan intracerebral blødning. Tidsskr Nor Laegeforen 2007; 127: 1064-8. Tidsskrift for Den norske legeforening  
  25. Dennis M, Sandercock P, Graham C, Forbes J.. The Clots in Legs Or sTockings after Stroke (CLOTS) 3 trial: a randomised controlled trial to determine whether or not intermittent pneumatic compression reduces the risk of post-stroke deep vein thrombosis and to estimate its cost-effectiveness.. Health Technol Assess. 2015; Sep;19(76):: 1-90. pmid: 26307376 PubMed  
  26. Sprügel MI, et al. 1. Heparin for prophylaxis of venous thromboembolism in intracerebral haemorrhage.. J Neurol Neurosurg Psychiatry. 2019. pmid:30992334 PubMed  
  27. Ianosi B1,2, Gaasch M2, Rass V2, Huber L1, Hackl W1, Kofler M2, Schiefecker AJ2, Addis A2,3, Beer R2, Rhomberg P4, Pfausler B2, Thomé C5, Ammenwerth E1, Helbok R2.. Early thrombosis prophylaxis with enoxaparin is not associated with hematoma expansion in patients with spontaneous intracerebral hemorrhage. Eur J Neurol. 2019 . pmid:30308696 PubMed  
  28. De Herdt V, Dumont F, Hénon H, Derambure P, Vonck K, Leys D, Cordonnier C. Early seizures in intracerebral hemorrhage: Incidence, associated factors, and outcome. Neurology. 2011; 77:1794-800. PMID: 21975203 PubMed  
  29. Poli D, Antonucci E, Dentali F, Erba N, Testa S, Tiraferri E, Palareti G; Italian Federation of Anticoagulation Clinics (FCSA). Recurrence of ICH after resumption of anticoagulation with VK antagonists: CHIRONE study. Neurology 2014; 82: 1020-6. pmid:24562060 PubMed  
  30. Flint AC, Conell C, Rao VA, Klingman JG, Sidney S, Johnston SC, Hemphill JC, Kamel H, Davis SM, Donnan GA.. Effect of statin use during hospitalization for intracerebral hemorrhage on mortality and discharge disposition.. JAMA Neurol. 2014; Nov;71(11):: 1364-71. pmid:25244578 PubMed  
  31. Perry LA1, Berge E2, Bowditch J1, Forfang E2, Rønning OM3, Hankey GJ4, Villanueva E5, Al-Shahi Salman R6.. Antithrombotic treatment after stroke due to intracerebral haemorrhage. Cochrane Database Syst Rev. 2017. pmid:28540976 PubMed  
  32. Frol S, Šabovič M, Oblak JP. Re-initiation of anticoagulation after central nervous system hemorrhage during treatment with direct oral anticoagulants: a single hospital cohort study. Neurol Sci. 2020 Sep 30. PMID: 32995994. PubMed  
  33. Stanton RJ, Eckman MH, Woo D, Moomaw CJ, Haverbusch M, Flaherty ML, Kleindorfer DO. Ischemic Stroke and Bleeding: Clinical Benefit of Anticoagulation in Atrial Fibrillation After Intracerebral Hemorrhage. Stroke. 2020 Mar;51(3):808-814. doi: 10.1161/STROKEAHA.119.027370. Epub 2020 Jan 31. Erratum in: Stroke. 2020 May;51(5):e100. PMID: 32000590 PubMed  
  34. SoSTART Collaboration. Effects of oral anticoagulation for atrial fibrillation after spontaneous intracranial haemorrhage in the UK: a randomised, open-label, assessor-masked, pilot-phase, non-inferiority trial. Lancet Neurol. 2021 Oct;20(10):842-853. doi: 10.1016/S1474-4422(21)00264-7. Epub 2021 Sep 3. PMID: 34487722. PubMed  
  35. Cea Soriano L, Gaist D, Soriano-Gabarró M, Bromley S, García Rodríguez LA. Neurology. 2017 Nov 28;89(22):2280-2287. PMID: 29093065 PubMed  
  36. Al-Shahi Salman R, Minks DP, Mitra D, Rodrigues MA, Bhatnagar P, du Plessis JC, Joshi Y, Dennis MS, Murray GD, Newby DE, Sandercock PAG, Sprigg N, Stephen J, Sudlow CLM, Werring DJ, Whiteley WN, Wardlaw JM, White PM;. Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial.. Lancet Neurol. 2019. pmid:31129065 PubMed  
  37. RESTART Collaboration.. Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial.. Lancet 2019. pmid:31128924 PubMed  
  38. Al-Shahi Salman R, Dennis MS, Sandercock PAG, Sudlow CLM, Wardlaw JM, Whiteley WN, Murray GD, Stephen J, Rodriguez A, Lewis S, Werring DJ, White PM; RESTART Collaboration. Effects of Antiplatelet Therapy After Stroke Caused by Intracerebral Hemorrhage: Extended Follow-up of the RESTART Randomized Clinical Trial. JAMA Neurol. 2021 Oct 1;78(10):1179-1186. doi: 10.1001/jamaneurol.2021.2956. PMID: 34477823; PMCID: PMC8417806.
  39. Tveiten A, Ljøstad U, Mygland A, Thomassen L, Pripp AH, Naess H. Intracerebral hemorrhage in southern Norway--a hospital-based incidence study. Eur Neurol 2012; 67: 240-5. PMID: 22433160 PubMed  
  40. Poon MT, Fonville AF, Al-Shahi Salman R. Long-term prognosis after intracerebral haemorrhage: systematic review and meta-analysis. Neurol Neurosurg Psychiatry 2014 ; 85: 660-7. pmid:24262916 PubMed  
  41. Zahuranec DB, Fagerlin A, Sánchez BN, Roney ME, Thompson BB, Fuhrel-Forbis A, Morgenstern LB. Variability in physician prognosis and recommendations after intracerebral hemorrhage. Neurology. 2016 May 17;86(20):1864-71 . pmid:27164665 PubMed  
  42. Fortes Lima TT, Prandini MN, Gallo P, Cavalheiro S. Prognostic Value of Intraventricular Bleeding in Spontaneous Intraparenchymal Cerebral Hemorrhage of Small Volume: A Prospective Cohort Study. Neurosurgery PMID: 21993187 PubMed  
  43. Tveiten A, Ljøstad U, Mygland A, Naess H. Leukoaraiosis is Associated with Short- and Long-term Mortality in Patients with Intracerebral Hemorrhage. J Stroke Cerebrovasc Dis 2013; 22: 919-25. PMID: 23433781 PubMed  
  44. Murthy SB, Urday S, Beslow LA, Dawson J, Lees K, Kimberly WT, Iadecola C, Kamel H, Hanley DF, Sheth KN, Ziai WC; VISTA ICH Collaborators. Rate of perihaematomal oedema expansion is associated with poor clinical outcomes in intracerebral haemorrhage. J Neurol Neurosurg Psychiatry. 2016 Nov;87(11):1169-1173 . pmid:27466360 PubMed  
  45. Steiner T, Al-Shahi Salman R, Beer R, Christensen H, Cordonnier C, Csiba L, Forsting M, Harnof S, Klijn CJ, Krieger D, Mendelow AD, Molina C, Montaner J, Overgaard K, Petersson J, Roine RO, Schmutzhard E, Schwerdtfeger K, Stapf C, Tatlisumak T, Thomas BM, Toni D, Unterberg A, Wagner M. European Stroke Organisation (ESO) guidelines for the management of spontaneous intracerebral hemorrhage. Int J Stroke 2014; 9: 840-55. pmid:25156220 PubMed  
  • Ole Morten Rønning, spesialist i nevrologi, professor dr med
  • Unn Ljøstad, spesialist i nevrologi, professor, PhD
  • Åse Mygland, spesialist i nevrologi, professor dr med

Tidligere fagmedarbeidere

  • Arnstein Tveiten, spesialist i nevrologi, PhD
  • Christian Lund, spesialist i nevrologi, dr med