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Review
. 2017 Jan;19(1):28-39.
doi: 10.5853/jos.2016.01935. Epub 2016 Jan 31.

Spontaneous Intracerebral Hemorrhage: Management

Jun Yup Kim  1 , Hee-Joon Bae  1
Affiliations
Review

Spontaneous Intracerebral Hemorrhage: Management

Jun Yup Kim et al. J Stroke. 2017 Jan.

Abstract

Spontaneous non-traumatic intracerebral hemorrhage (ICH) remains a significant cause of mortality and morbidity throughout the world. To improve the devastating course of ICH, various clinical trials for medical and surgical interventions have been conducted in the last 10 years. Recent large-scale clinical trials have reported that early intensive blood pressure reduction can be a safe and feasible strategy for ICH, and have suggested a safe target range for systolic blood pressure. While new medical therapies associated with warfarin and non-vitamin K antagonist oral anticoagulants have been developed to treat ICH, recent trials have not been able to demonstrate the overall beneficial effects of surgical intervention on mortality and functional outcomes. However, some patients with ICH may benefit from surgical management in specific clinical contexts and/or at specific times. Furthermore, clinical trials for minimally invasive surgical evacuation methods are ongoing and may provide positive evidence. Upon understanding the current guidelines for the management of ICH, clinicians can administer appropriate treatment and attempt to improve the clinical outcome of ICH. The purpose of this review is to help in the decision-making of the medical and surgical management of ICH.

Keywords: Cerebral hemorrhage; Cerebrovascular disorders; Intracranial hemorrhages; Stroke; Therapeutics.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Figure 1.
Figure 1.
The ICH Score and 30-day mortality. Data were revised from Hemphill JC 3rd, Bonovich DC, Besmertis L, Manley GT, Johnston SC. The ICH score: a simple, reliable grading scale for intracerebral hemorrhage. Stroke 2001;32:891-897. There was no patient with a score of 6 in the cohort, but an ICH score of 6 would be predicted to be associated with a high risk of mortality.
See this image and copyright information in PMC

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