Division of Trauma, Jersey Shore University Medical Center, Neptune, New Jersey, United States. Division of Trauma and Surgical Critical Care, Jersey Shore University Medical Center, Neptune, New Jersey, United States. Hackensack Meridian School of Medicine, Nutley, New Jersey, United States.
Journal of neurological surgery. Part A, Central European neurosurgery. 2022
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.
