J Stroke.  2017 Jan;19(1):28-39. 10.5853/jos.2016.01935.

Spontaneous Intracerebral Hemorrhage: Management

• Kim JY
• Bae HJ

• KMID: 2368399
• DOI: http://doi.org/10.5853/jos.2016.01935

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.

Keyword

Stroke; Cerebrovascular disorders; Intracranial hemorrhages; Cerebral hemorrhage; Therapeutics

MeSH Terms

Anticoagulants
Blood Pressure
Cerebral Hemorrhage*
Cerebrovascular Disorders
Humans
Intracranial Hemorrhages
Mortality
Stroke
Warfarin
Anticoagulants
Warfarin