Early surgery may not be needed in brain haemorrhage

Reported by Susan Aldridge, PhD, medical journalist

A comparison shows that early surgery does not give a better outcome than conservative treatment in brain haemorrhage.
Around 20 in 100,000 people a year are affected by spontaneous brain haemorrhage. It's a very serious condition with a death rate of around 40 per cent. Many survivors are disabled.

The usual approach is to give surgery to remove any blood clot as soon as possible. But, according to a new study from the University of Newcastle Upon Tyne, England, this may not be strictly necessary. They have compared outcomes in a group of over 1,000 patients with brain haemorrhage, some of whom had surgery while others had conservative treatment, including medication.

The investigators found that 26 per cent of the patients having early surgery had a favorable outcome at six months compared to 24 per cent of those having conservative treatment. Mortality was 36 per cent in the surgery group and 37 per cent in the conservative group. Only those with small clots, of one centimeter or less, on the brain surface did better with surgery. This study suggests that the usual policy of giving patients with a brain haemorrhage early surgery may not be the best one.

Source
The Lancet 29th January 2005

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