чаво расчитаны на пациентов, а показания в оперативном лечении внутримозговых гематом строго индивидуальны и решение принимается консилиумом (приказ МЗ №928н),
но объективности ради : в рекомендациях и нет запрета на хирургическое лечение супратенториальных гематом. Trials have not shown a benefit for surgery in supratentorial ICH, but this could be considered as a lifesaving measure in deteriorating patients. n patients who are comatose or have significant mass effect from a supratentorial hematoma, decompressive craniectomy may be lifesaving. Surgical treatment of ICH is an area of ongoing active research.
кроме того имеются данные о серьезном снижении смертности при крупноочаговых инфарктах головного мозга
All 3 European trials showed a significant reduction in mortality in surgically treated patients as compared with the conservatively treated groups.In DECIMAL, the absolute risk reduction for mortality at 6 months was 53% with hemicraniectomy. 12 DESTINY reached significance for 30-day mortality (12% with surgery versus 53% with conservative management) after enrollment of 32 patients. 13 In HAMLET, surgical treatment also led to improved survival with an absolute risk reduction of 38%. 14 However, none of the 3 RCTs could demonstrate a significant benefit of hemicraniectomy considering functional outcome as defined in the primary outcome measures
stroke.ahajournals.org/content/42/2/513.full
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Филиппов Павел Геннадьевич.
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