Intracranial Hemorrhage and Intracranial Hypertension

Abstract

Central nervous system hemorrhage has multiple pathophysiologic etiologies, including intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and traumatic brain injury (TBI). Given the nuances intrinsic to each of these etiologies and pathophysiologic processes, optimal blood pressure varies significantly and depends on type of hemorrhage and individual characteristics. This article reviews the most current evidence regarding blood pressure targets and provides guidance on reversal of anticoagulation for TBI, ICH, and SAH. It also describes the assessment, optimal therapeutic targets, and interventions to treat intracranial hypertension that can result from TBI, ICH, or SAH.

Keywords: Anticoagulation; Blood pressure; Herniation; ICP monitoring; Intracerebral hemorrhage; Intracranial hypertension; Subarachnoid hemorrhage; Traumatic brain injury.