The clinical management of acute intracerebral hemorrhage

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

Intracerebral hemorrhage (ICH) is a stroke subtype with high mortality and significant disability among survivors. The management of ICH has been influenced by the results of several major trials completed in the last decade. It is now recognized that hematoma expansion is a major cause of morbidity and mortality. However, efforts to improve clinical outcome through mitigation of hematoma expansion have so far been unsuccessful. Acute blood pressure management has recently been shown to be safe in the setting of acute ICH but there was no reduction in mortality with early blood pressure (BP) lowering. Two large trials of surgical evacuation of supratentorial ICH have not shown improvement in outcome with surgery, thus minimally invasive surgical strategies are currently being studied. Lastly, a better understanding of the pathophysiology of ICH has led to the identification of several new mechanisms of injury that could be potential therapeutic targets.

Original languageEnglish (US)
Pages (from-to)1421-1432
Number of pages12
JournalExpert review of neurotherapeutics
Volume15
Issue number12
DOIs
StatePublished - Dec 1 2015

Keywords

  • blood pressure
  • cerebral hemorrhage
  • edema
  • hematoma
  • hematoma expansion
  • hydrocephalus
  • intracranial pressure
  • medical management
  • neuroimaging
  • stroke

ASJC Scopus subject areas

  • General Neuroscience
  • Clinical Neurology
  • Pharmacology (medical)

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