Update on intracerebral hemorrhage.
OBJECTIVE
This article provides an update on the latest diagnostic and therapeutic trials relating to the management of intracerebral hemorrhage (ICH).


RESULTS
Early hematoma expansion and worsening cerebral edema may account for delayed neurologic deterioration after ICH.


CONCLUSIONS
Despite advances in other areas of stroke, there has been no significant improvement in the morbidity and mortality after ICH. The cause of ICH has been shifting from chronic hypertension to other etiologies. Current understanding of the pathophysiologic processes involved with hematoma expansion and the development of secondary injury after ICH has focused the treatment strategies on prevention of these potential complications. Care for the patient after ICH includes basic medical care, prevention of hematoma expansion, and treatment of potential secondary complications. Trials are underway to evaluate the effect of acute blood pressure control on hematoma expansion and the development of cerebral edema. Similarly, new surgical techniques are being explored for clot removal, and medical therapies are being developed to prevent secondary neurotoxic damage.
Neurological Intensive Care Unit, Cleveland Clinic, 9500 Euclid Ave, Desk S 80, Cleveland, OH 44195, USA. mannoe@ccf.org
Edward M
EM
Manno
D000925:Anticoagulants / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001925:Brain Damage, Chronic / Q000209:etiology / Q000517:prevention & control; D001929:Brain Edema / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D016657:Cerebral Amyloid Angiopathy / Q000150:complications; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery / Q000628:therapy; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods*; D004630:Emergencies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D019586:Intracranial Hypertension / Q000209:etiology / Q000517:prevention & control; D008020:Life Support Care; D015337:Multicenter Studies as Topic; D059906:Neuroimaging; D012307:Risk Factors; D012720:Severity of Illness Index; D015912:Thrombolytic Therapy
D000925:Anticoagulants; D000959:Antihypertensive Agents