RESUMO
OBJECTIVES: Acute intracerebral hemorrhage (ICH) is a very common cause of disability. Previous evidence suggests that fluoxetine and other selective serotonin reuptake inhibitors improve, the recovery of motor function in patients with cerebral infarct. The purpose of this study was to investigate whether fluoxetine also improves motor recovery in patients with ICH. PATIENTS AND METHODS: This is a double blind, placebo controlled, multicenter randomized trial, patients recruited from three centers were assigned to receive 20â¯mg/day of fluoxetine or matching placebo for three months from within ten days after onset of symptoms. Primary outcome was change in Fugl-Meyer Motor Scale from baseline to day 90. RESULTS: Thirty patients (50 % women) were recruited to the fluoxetine (nâ¯=â¯14) or placebo (nâ¯=â¯16) groups. Median age was 55 years, the cause of the ICH was hypertension in 93.3 %, median volume of the hematomas was 22mm3. Basal ganglia hematoma was present in 67 % and, lobar location in 20 % of the patients. Improvement in FMMS at day 90 was significatively higher in the treatment group (median score 23) than in the placebo group, (median score 48), pâ¯=â¯0.001. No serious adverse events occurred. CONCLUSION: In addition to standard treatment, early prescription of fluoxetine was safe and helped to increase motor recovery 90 days after ICH. This finding adds to the evidence regarding its beneficial effect upon stroke related disability. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01737541.
Assuntos
Fluoxetina/uso terapêutico , Acidente Vascular Cerebral Hemorrágico/reabilitação , Recuperação de Função Fisiológica , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Idoso , Hemorragia dos Gânglios da Base/tratamento farmacológico , Hemorragia dos Gânglios da Base/fisiopatologia , Hemorragia dos Gânglios da Base/reabilitação , Método Duplo-Cego , Feminino , Acidente Vascular Cerebral Hemorrágico/tratamento farmacológico , Acidente Vascular Cerebral Hemorrágico/fisiopatologia , Humanos , Hemorragia Intracraniana Hipertensiva/tratamento farmacológico , Hemorragia Intracraniana Hipertensiva/fisiopatologia , Hemorragia Intracraniana Hipertensiva/reabilitação , Masculino , Pessoa de Meia-Idade , Reabilitação do Acidente Vascular Cerebral , Resultado do TratamentoRESUMO
BACKGROUND: Bilateral traumatic basal ganglia haematoma is an extremely rare event in traumatic brain injuries, with only five reported cases. The presumed mechanism is due to shearing forces leading to haemorrhage from the lenticulostriate or anterior choroidal artery. The prognosis appears to be dependent on the extent and severity of underlying brain injury. CASE STUDY: A case of a 38 year old fully conscious male, who presented with bilateral basal ganglia haematoma and extradural haematoma, is presented and the relevant literature is briefly reviewed.
