Current Treatment Options in Neurology

, Volume 10, Issue 6, pp 455-467

First online:

Treatment of acute intracerebral hemorrhage

  • Bart M. DemaerschalkAffiliated withDivisions of Cerebrovascular Diseases and Critical Care Neurology, Department of Neurology, Mayo Clinic Hospital Email author 
  • , Maria I. Aguilar

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Opinion statement

Intracerebral hemorrhage (ICH) is a neurologic emergency associated with regular, early, ongoing hemorrhage, progressive clinical deterioration, severe deficits, and high mortality. Hence, it requires prompt recognition, diagnosis, and management. Initial monitoring and management of patients with ICH should occur in an intensive care unit. The overall approach to treatment mandates using therapies to stop or slow the initial bleeding acutely, removing blood from the parenchyma or ventricles (in eligible patients) to prevent secondary brain injury, addressing raised intracranial pressure, and providing good, comprehensive supportive care, including management of airways, oxygenation, blood pressure, circulation, glucose level, fever, and nutrition, as well as deep venous thrombosis prophylaxis.