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Drill treatment could help patients with brain hemorrhage

By Tauren Dyson

Feb. 8 (UPI) -- A brain hemorrhage treatment that involves drilling a hole in the skull to drain accumulated blood could cut down on the number of stroke deaths, a new study says.

About 59 percent of brain hemorrhage patients who received the aggressive treatment had blood clots reduced, according to a study presented Thursday at the American Heart Association's International Stroke Conference.

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"We found that for surgeons treating a brain hemorrhage, it is critical to maximize the amount of blood the surgeon can safely remove from the site," study leader Issam Awad, director of Neurovascular Surgery at the University of Chicago Medicine and study author, said in a news release. "Unless at least 70 percent of the clot is promptly removed and only a very small residual amount of blood remains, the potential benefits of surgery will not be realized."

Hemorrhagic strokes account for 12 percent of all strokes, but cause roughly 40 percent of all stroke deaths. Most of these strokes result from high blood pressure. Following brain hemorrhage, researchers say that at least 70 percent of the blood has to be removed for the patient to properly recover.

"This cannot be taken for granted," Awad said. "Intracerebral hemorrhage is a catastrophic illness. When surgery is performed, we must be certain that the blood is in fact removed. Surprisingly, this had not been considered in assessing the effectiveness of surgery. This is the first surgical trial to demonstrate a clear and urgent goal for reduction of intracerebral hemorrhage volume."

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For the research, the scientists drilled a tiny hole in the skull of the patient and inserted a small tube which shoots the drug alteplase onto the dried blood in the brain. This drug reduced blood clot sizes to 15 milliliters or less, and in some cases, smaller than 5 milliliters.

About one in 20 people in the United States have had strokes, according to the Centers for Disease Control and Prevention. It is the fifth leading cause of death in the country.

"If you get half of the clot out, you can save the person's life," Awad said. "But to get real functional benefit, you have to go all the way. You have to remove most, if not all, of the clot."

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