Early Surgery No Benefit for Brain Hemorrhage

Conservative medical treatment just as effective, study finds

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THURSDAY, Jan. 27, 2005 (HealthDayNews) -- Early surgery isn't better than conservative medical treatment for people with a brain hemorrhage, according to a British study in this week's issue of The Lancet.

The study noted there are two treatment options -- surgery or medical treatment -- for spontaneous brain hemorrhage, which is bleeding in the brain caused by the rupture of a blood vessel. It affects about 20 in 100,000 people each year. The death rate is about 40 percent, and most survivors are left disabled.

Researchers at the University of Newcastle Upon Tyne assessed whether early surgery was more effective than medical treatment at reducing deaths and disability caused by brain hemorrhage. The study included more than 1,000 patients, average age 62, with brain hemorrhage; 503 received early surgery and 530 received initial conservative treatment.

The study found that 26 percent of the early surgery patients had a favorable outcome at six months, compared with 24 percent of those who received conservative treatment. The death rate for the surgery group was 36 percent, compared to 37 percent for the conservative treatment group.

"There is insufficient evidence to justify a general policy of early operative interventions in patients with spontaneous brain hemorrhage, compared with initial conservative treatment. Patients with superficial blood clots might benefit from surgery, but this beneficial effect needs to be established," researcher David Mendelow said in a prepared statement.

More information

The U.S. National Library of Medicine has more about brain hemorrhage.

SOURCE: The Lancet; news release, Jan. 27, 2005

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