Hyperacute Medical Management of Intracerebral Haemorrhage

Abstract

Intracerebral haemorrhage (ICH) is caused by spontaneous, non-traumatic haemorrhage within the brain parenchyma. ICH has poor outcomes, with a 30-40% 1-month case fatality and most survivors remaining dependent. Current management of ICH is aimed at providing appropriate supportive care and reducing the risk of haematoma expansion, which affects up to 20-30% of patients in the first 24 hours. Rapid and intensive blood pressure lowering to a pre-specified target and reversal of anticoagulants in the 20% of patients who are taking them may reduce the risk of expansion and improve outcome.