Minimally invasive surgery plus alteplase for intracerebral haemorrhage

Stroke has become the second largest contributor to disability-adjusted life-years (DALYs) lost globally. 1 Feigin VL Krishnamurthi RV Parmar P et al. Update on the global burden of ischemic and hemorrhagic stroke in 1990–2013: the GBD 2013 study. Neuroepidemiology. 2015; 45: 161-176 Crossref PubMed Scopus (814) Google Scholar Because of the severity of haemorrhagic stroke, particularly as a result of intracerebral haemorrhage, this condition accounts for more DALYs lost than ischaemic stroke. 1 Feigin VL Krishnamurthi RV Parmar P et al. Update on the global burden of ischemic and hemorrhagic stroke in 1990–2013: the GBD 2013 study. Neuroepidemiology. 2015; 45: 161-176 Crossref PubMed Scopus (814) Google Scholar Despite more than 100 randomised trials 2 Tamborska A Poon MTC Al-Shahi Salman R Characteristics of randomized trials focusing on stroke due to intracerebral hemorrhage: systematic Review. Stroke. 2018; 49: 594-600 Crossref PubMed Scopus (5) Google Scholar assessing various treatments, organised stroke unit care remains the mainstay of therapy to improve outcome after intracerebral haemorrhage. 3 Langhorne P Fearon P Ronning OM et al. Stroke unit care benefits patients with intracerebral hemorrhage: systematic review and meta-analysis. Stroke. 2013; 44: 3044-3049 Crossref PubMed Scopus (111) Google Scholar , 4 Schreuder FH Sato S Klijn CJ Anderson CS Medical management of intracerebral haemorrhage. J Neurol Neurosurg Psychiatry. 2017; 88: 76-84 Crossref PubMed Scopus (24) Google Scholar Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trialFor moderate to large intracerebral haemorrhage, MISTIE did not improve the proportion of patients who achieved a good response 365 days after intracerebral haemorrhage. The procedure was safely adopted by our sample of surgeons. Full-Text PDF