Hemorajik İnme

Özet

Hemorajik inme küresel ölçekte yıllık yaklaşık 1 trilyon dolar ekonomik kayba ve inmeye bağlı ölümlerin yaklaşık yarısına neden olmaktadır. Ülkemizde ise inme prevelansı %1,3 olup, bunun içerisinde hemorajik inme %24’lük orana sahip bir toplum sağlığı sorunu olarak karşımızda durmaktadır. Etyolojisi incelendiğinde ise birçok nedenin hipertansiyon, DM, sigara ve madde kullanımı gibi önlenebilir veya tedavi edilebilir nedenler olduğu görülmektedir. Hastalık ortaya çıktığında ise erken tanı ve müdahale ön plana çıkmaktadır. Örneğin antihipertansif tedavinin erken başlanması veya anti-trombotik tedavilerin geriye çevrilmesi bu kapsamda değerlendirilmektedir. Biz sağlık profesyonellerine düşen görev toplumsal bilinçlendirme ve ilgili sağlık çalışanları açısından hizmet içi eğitimlerin yeterli düzeyde yaygınlaştırılması olarak görünmektedir.

Referanslar

Gerstl JV, Blitz SE, Qu QR, et al. Global, regional, and national economic consequences of stroke. Stroke. 2023; 54(9): 2380-2389.

Unnithan AKA, Das JM and Mehta P. Hemorrhagic Stroke (2024). Available from: https://www.ncbi.nlm.nih.gov/books/NBK559173/ (accessed 28.04.2025).

Parry-Jones AR, Krishnamurthi R, Ziai WC, et al. World Stroke Organization (WSO): Global intracerebral hemorrhage factsheet 2025. International Journal of Stroke. 2025; 20(2): 145-150.

Topçuoğlu MA. Stroke epidemiology and near future projection in Turkey: analysis of Turkey data from the Global Burden of Disease Study. Turkish Journal of Neurology. 2022; 28(4): 200-211.

Louis RC and Carlos SK. Intracerebral Hemorrhage. Louis RC (ed). Caplan’s Stroke fifth edition (in). Cambridge CB2 8BS, United Kingdom: Cambridge University Press; 2016. p. 477-510.

Magaki S, Chen Z, Haeri M, et al. Charcot–Bouchard aneurysms revisited: clinicopathologic correlations. Modern Pathology. 2021; 34(12): 2109-2121.

Lee TH. Intracerebral hemorrhage. Cerebrovascular Diseases Extra. 2025; 15(1): 1-8.

Allan HR, Martin AS, Joshua PK, et al. Adams and victor's principles of neurology (twelfth edition). New York: McGraw Hill Education; 2023.

Huang B, Chen A, Sun Y, et al. The role of aging in Intracerebral Hemorrhage. Brain Sciences. 2024; 14(6): 613 (1-20).

Leasure AC, King ZA, Torres-Lopez V, et al. Racial/ethnic disparities in the risk of intracerebral hemorrhage recurrence. Neurology. 2020; 94(3): 314-322.

Krishnan K, Beishon L, Berge E, et al. Relationship between race and outcome in Asian, Black, and Caucasian patients with spontaneous intracerebral hemorrhage: Data from the Virtual International Stroke Trials Archive and Efficacy of Nitric Oxide in Stroke trial. International Journal of Stroke. 2018; 13(4): 362-373.

An SJ, Kim TJ, Yoon BW. Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: an update. Journal of stroke. 2017; 19(1): 3-10.

Svensson EH, Abul-Kasim K, Engström G, et al. Risk factors for intracerebral haemorrhage–results from a prospective population-based study. European Stroke Journal, 2020; 5(3): 278-285.

Cho S, Rehni AK, Dave KR. Tobacco use: a major risk factor of intracerebral hemorrhage. Journal of stroke. 2021; 23(1): 37-50.

Thangameeran SIM, Wang PK, Liew HK, et al. Influence of alcohol on intracerebral hemorrhage: from oxidative stress to glial cell activation. Life. 2024; 14(3): 311 (1-19).

Rehm J. The risks associated with alcohol use and alcoholism. Alcohol Research & Health. 2011; 34(2): 135 (1-15).

Putri RA, Diansyah MN, Ashariati A, Bintoro, et al. Diathesis Hemorrhagic, Coagulation and fibrinolytic system. Biomolecular Healath Science Journal. 2022; 5(1): 54-61.

Magid Bernstein J, Girard R, Polster S, et al. Cerebral hemorrhage: pathophysiology, treatment, and future directions. Circulation research. 2022; 130(8): 1204-1229.

Mehndiratta P, Manjila S, Ostergard T, et al. Cerebral amyloid angiopathy–associated intracerebral hemorrhage: pathology and management. Neurosurgical focus. 2012; 32(4): E7 (1-14).

Greenberg SM and van Veluw SJ. Cerebral amyloid angiopathy. Stroke. 2024; 55(5): 1409-1411.

Cepeda S, Gómez PA, Castaño-Leon AM, et al. Traumatic intracerebral hemorrhage: risk factors associated with progression. Journal of neurotrauma. 2015; 32(16): 1246-1253.

Tartarin H, Morotti A, Van Etten ES, et al. Uncommon causes of nontraumatic intracerebral hemorrhage. Stroke. 2024; 55(5): 1416-1427.

Kumar S. Hypertension and hemorrhagic stroke. Hypertension Journal. 2017; 3(2): 89-93.

Rocha E, Rouanet C, Reges D, et al. Intracerebral hemorrhage: update and future directions. Arquivos de Neuro-Psiquiatria. 2020; 78(10): 651-659.

Hillal A, Ullberg T, Ramgren B, et al. Computed tomography in acute intracerebral hemorrhage: neuroimaging predictors of hematoma expansion and outcome. Insights into imaging. 2022; 13(1): 180 (1-16).

Li Z, You M, Long C, et al. Hematoma expansion in intracerebral hemorrhage: an update on prediction and treatment. Frontiers in neurology. 2020; 11: 702 (1-13).

Bushnell C, Kernan WN, Sharrief AZ, et al. 2024 Guideline for the primary prevention of stroke: a guideline from the American Heart Association/American Stroke Association. Stroke. 2024; 55(12): 344-424.

McEvoy JW, McCarthy CP, Bruno RM, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eurropean Heart Journal. 2024; 45(38): 3912-4018.

Cao Y, Yu S, Zhang Q, et al. Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of intracerebral haemorrhage. Stroke and Vascular Neurology. 2020; 5(4): 296-402.

Mutimer CA, Yassi N and Wu TY. Blood Pressure Management in Intracerebral Haemorrhage: when, how much, and for how long?. Current neurology and neuroscience reports. 2024; 24(7): 181-189.

Greenberg SM, Ziai WC, Cordonnier C, et al. American Heart Association/American Stroke Association. (2022). 2022 guideline for the management of patients with spontaneous intracerebral hemorrhage: a guideline from the American Heart Association/American Stroke Association. Stroke. 2022; 53(7): 282-361.

Schrag M and Kirshner H. Management of intracerebral hemorrhage: JACC focus seminar. Journal of the American College of Cardiology. 2020; 75(15): 1819-1831.

Yang J, Jing J, Chen S, et al. Reversal and resumption of anticoagulants in patients with anticoagulant-associated intracerebral hemorrhage. European Journal of Medical Research. 2024; 29(1): 252 (1-19).

Wan Y, Holste KG, Hua Y, et al. Brain edema formation and therapy after intracerebral hemorrhage. Neurobiology of disease. 2023; 176: 105948 (1-34).

Patel S, Maria-Rios J, Parikh A, et al. Diagnosis and management of elevated intracranial pressure in the emergency department. International Journal of Emergency Medicine. 2023; 16(1): 72(1-9).

Harary M, Dolmans RG and Gormley WB. Intracranial pressure monitoring—review and avenues for development. Sensors. 2018; 18(2): 465 (1-15).

Moraes FMD and Silva GS. Noninvasive intracranial pressure monitoring methods: a critical review. Arquivos de neuro-psiquiatria. 2021; 79(5): 437-446.

Dammers R, Beck J, Volovici V, et al. Advancing the surgical treatment of intracerebral hemorrhage: study design and research directions. World Neurosurgery. 2022; 161: 367-375.

Hanley DF, Thompson RE, Rosenblum M, et al. Minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label phase 3 trial with blinded endpoint. Lancet (London, England). 2019; 393(10175): 1021-1032.

Broderick JP. The STICH trial: what does it tell us and where do we go from here?. Stroke. 2005; 36(7): 1619-1620.

Zheng Z, Wang Q, Sun S, et al. Minimally invasive surgery for intracerebral and intraventricular hemorrhage. Frontiers in neurology. 2022; 13: 755501 (1-14).

De Oliveira Manoel AL. Surgery for spontaneous intracerebral hemorrhage. Critical Care. 2020; 24(1): 45 (1-19).

Demir O and Deniz FE. A clinical experience with decompressive craniectomy. Turkish Neurosurgery. 2020; 30(5): 637-642.

Gelecek

21 Ocak 2026

Lisans

Lisans