Therapeutic targets
Emergency neurosurgical intervention is required to save the patient’s life:
- Reduction of intracranial pressure and hematomevacuation (evacuation of the hematoma/bruise) (see “Surgical Therapy“).
Until then:
- Secure and stabilize vital functions
- Avoid secondary diseases and complications, e.g., posttraumatic cerebral edema
- If necessary, normalization of blood clotting
Therapy recommendations
- Preoperative intracranial pressure reduction:
- Upper body elevation (10-30°).
- Osmotherapy with a 20% mannitol solution (100-150 ml in 10-15 minutes).
- To normalize blood clotting:
- Fresh frozen plasma (FFP) – a blood product obtained from human donor blood, which contains the liquid and dissolved components of the blood; the cells of the blood (erythrocytes, leukocytes, platelets) have been largely removed by centrifugation; Caution: it should not be used without a clinically manifest bleeding tendency!
- Vitamin K
- Recombinant factor VIIa
- Low-dose (75-300 mg/day) continuous medication with acetylsalicylic acid (ASA; antiplatelet agent), as prescribed in the primary and secondary prevention of vascular events, does not increase the risk of intracranial hemorrhage.