２０１４/４/21

Risk factors of the Stroke

()

Centers for Disease Control and Prevention

Hg Hg2009

140mmHg 140 159mmHg

JATOS The Japanese Trial to Assess Optimal Systolic Blood Pressure in Elderly Hypertensive Patients

2009

The International Surgical Trial in Intracerebral Haemorrhage STICH)

N1033 Randomised ; Early surgery (503) vs Initial conservative treatment (530)

72

2cm Glasgow Coma Scale GCS >_5

Primary endpoint; Glasgow outcome score after 6 month

Secondary endopoint; modified Rankin scale Barthel index after 6 month

Lancet 2005 365 387-397

530 140 26STICH study

1cm STICH trial2009

Retrospective study

1) Dandapani BK . Stroke 1995 26 21-24 Meyer JS . Neurology 1962 12 36-47

2) Maruishi M. Neurol Med Chir Tokyo 2001 41 300-305

3) . 1997 19 432-436

Prospective study

Jauch EC. Stroke 2006 37 2061-2065

Broderick JP. Stroke 2007 38 1072-1075

The Intravenous Nimodipine West European Stroke Trial (INWEST) Nimodipine

Nimodipine

24 3

Nimodipine low-dose (1mg/h)n=101

Nimodipine high-dose (2mg/h)n=94

Placebo n=100

Nimodipine low-dose,high-dose Placebo

Nimodipine high-dose ( )

Nimodipine low-dose ( )

Ahmed N. Stroke 2000 31 1250-1255

Antihypertensive Treatment of Acute Cerebral Hemorrhage Trial

ATACH pilot study

ATACH

A.I. Qureshi Zeenat Qureshi Stroke Research Center, University of Minnesota

and National Institutes of Health grant

The Intensive Blood Reduction in Acute Cerebral Hemorrhage Trial

INTERACT1 pilot study

INTERACT2

Australian National Health and Medical Research Council

Hg

Hg

Stroke.2010;41:307-312

INTERACT1 Pilot –phase study N=404

INTERACT Main-phase study N=2839

Hg

Hg

Outcome Modified Rankin scale

N Engl J Med 2013;368:2355-65

INTERACT ATACH

INTERACT

Mayer SA. N Engl J Med 2005;352:777-785

ATACH

ATACH trial Pilot-phase study

Nicardipine

Hg

Hg

Hg

24 72

NicardipineA.I. Qureshi. Crit Care Med. 2010 Feb;38(2):637-48

ATACH trial phase study

Nicardipine

Hg

Hg

Primary hypothesis

Hg

INTERCT ATACHINTERACT ATACH GCS massive hematoma

GCS massive hematoma

SCU GCS