Skip to main content
SpringerLink
Log in

Prehospital and Emergency Department Management of Intracerebral Hemorrhage

  • Chapter
  • First Online:
Intracerebral Hemorrhage Therapeutics

Abstract

Intracerebral hemorrhage (ICH) is the second most common subtype of stroke and a critical disease usually leading to severe disability or death. Around 20% of patients with ICH will experience a decrease in the Glasgow Coma Scale of two or more points between the prehospital assessment and the initial evaluation in the emergency department (ED). Therefore, aggressive prehospital and ED treatment is cornerstone for effective management of patients with ICH. Initial management should focus on urgent stabilization of cardiorespiratory variables and treatment of intracranial complications. Recent technological innovations have opened new perspectives for stroke diagnosis and treatment before the patient arrives at the hospital. These prehospital measures include presumed stroke diagnosis by paramedics, mobile telemedicine for remote clinical examination and imaging, mobile stroke units with integrated computerized tomography (CT) scanners, point-of-care laboratories in ambulances, and prehospital notification provided by emergency medical staff (EMS). Primary management of ICH in ED includes rapid clinical evaluation, laboratory studies including blood glucose and coagulation defects, diagnostic imaging studies, management of blood pressure and early intracranial complications such as hydrocephalus or impending herniation, and admission to stroke unit or neuroscience intensive care unit (NICU). In this book chapter, we will discuss in detail about various prehospital and ED management strategies for management of patients with ICH.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Wang H, Naghavi M, Allen C, et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1459–544.

    Article  Google Scholar 

  2. Portegies ML, Koudstaal PJ, Ikram MA. Cerebrovascular disease. Handb Clin Neurol. 2016;138:239–61.

    Article  CAS  PubMed  Google Scholar 

  3. An SJ, Kim TJ, Yoon BW. Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: an update. J Stroke. 2017;19(1):3–10.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Gebel JM, Broderick JP. Intracerebral hemorrhage. Neurol Clin. 2000;18(2):419–38.

    Article  CAS  PubMed  Google Scholar 

  5. Grysiewicz RA, Thomas K, Pandey DK. Epidemiology of ischemic and hemorrhagic stroke: incidence, prevalence, mortality, and risk factors. Neurol Clin. 2008;26(4):871–95. vii

    Article  PubMed  Google Scholar 

  6. Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF. Spontaneous intracerebral hemorrhage. N Engl J Med. 2001;344(19):1450–60.

    Article  CAS  PubMed  Google Scholar 

  7. Vermeer SE, Algra A, Franke CL, Koudstaal PJ, Rinkel GJ. Long-term prognosis after recovery from primary intracerebral hemorrhage. Neurology. 2002;59(2):205–9.

    Article  CAS  PubMed  Google Scholar 

  8. Broderick JP, Brott TG, Duldner JE, Tomsick T, Huster G. Volume of intracerebral hemorrhage. A powerful and easy-to-use predictor of 30-day mortality. Stroke. 1993;24(7):987–93.

    Article  CAS  PubMed  Google Scholar 

  9. Moon JS, Janjua N, Ahmed S, et al. Prehospital neurologic deterioration in patients with intracerebral hemorrhage. Crit Care Med. 2008;36(1):172–5.

    Article  PubMed  Google Scholar 

  10. Brott T, Broderick J, Kothari R, et al. Early hemorrhage growth in patients with intracerebral hemorrhage. Stroke. 1997;28:1–5.

    Article  CAS  PubMed  Google Scholar 

  11. Fan JS, Huang HH, Chen YC, et al. Emergency department neurologic deterioration in patients with spontaneous intracerebral hemorrhage: incidence, predictors, and prognostic significance. Acad Emerg Med. 2012;19:133–8.

    Article  PubMed  Google Scholar 

  12. Elliott J, Smith M. The acute management of intracerebral hemorrhage: a clinical review. Anesth Analg. 2010;110(5):1419–27.

    Article  PubMed  Google Scholar 

  13. Audebert HJ, Saver JL, Starkman S, Lees KR, Endres M. Prehospital stroke care: new prospects for treatment and clinical research. Neurology. 2013;81(5):501–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Morgenstern LB, Staub L, Chan W, et al. Improving delivery of acute stroke therapy: the TLL temple foundation stroke project. Stroke. 2002;33(1):160–6.

    Article  PubMed  Google Scholar 

  15. Williams O, Noble JM. 'Hip-hop' stroke: a stroke educational program for elementary school children living in a high-risk community. Stroke. 2008;39(10):2809–16.

    Article  PubMed  Google Scholar 

  16. Morgenstern LB, Gonzales NR, Maddox KE, et al. A randomized, controlled trial to teach middle school children to recognize stroke and call 911: the kids identifying and defeating stroke project. Stroke. 2007;38(11):2972–8. Epub 2007 Sep 20

    Article  PubMed  Google Scholar 

  17. Hodgson C, Lindsay P, Rubini F. Can mass media influence emergency department visits for stroke? Stroke. 2007;38(7):2115–22. Epub 2007 May 31

    Article  PubMed  Google Scholar 

  18. Mohammad YM. Mode of arrival to the emergency department of stroke patients in the United States. J Vasc Interv Neurol. 2008;1(3):83–6.

    PubMed  PubMed Central  Google Scholar 

  19. Wester P, Rådberg J, Lundgren B, et al. Factors associated with delayed admission to hospital and in-hospital delays in acute stroke and TIA: a prospective, multicenter study.Seek- medical-attention-in-time study group. Stroke. 1999;30(1):40–8.

    Article  CAS  PubMed  Google Scholar 

  20. Rosamond WD, Gorton RA, Hinn AR, et al. Rapid response to stroke symptoms: the delay in accessing stroke healthcare (DASH) study. Acad Emerg Med. 1998;5(1):45–51.

    Article  CAS  PubMed  Google Scholar 

  21. Hemphill JC 3rd, Greenberg SM, Anderson CS, et al. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015;46(7):2032–60.

    Article  PubMed  Google Scholar 

  22. Acker JE 3rd, Pancioli AM, Crocco TJ, et al. Implementation strategies for emergency medical services within stroke systems of care: a policy statement from the American Heart Association/American Stroke Association expert panel on emergency medical services systems and the stroke council. Stroke. 2007;38(11):3097–115.

    Article  PubMed  Google Scholar 

  23. Abdullah AR, Smith EE, Biddinger PD, et al. Advance hospital notification by EMS in acute stroke is associated with shorter door-to-computed tomography time and increased likelihood of administration of tissue-plasminogen activator. Prehosp Emerg Care. 2008;12(4):426–31.

    Article  PubMed  Google Scholar 

  24. Buck BH, Starkman S, Eckstein M, et al. Dispatcher recognition of stroke using the National Academy Medical Priority Dispatch System. Stroke. 2009;40(6):2027–30.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Reginella RL, Crocco T, Tadros A, et al. Predictors of stroke during 9-1-1 calls: opportunities for improving EMS response. Prehosp Emerg Care. 2006;10(3):369–73.

    Article  PubMed  Google Scholar 

  26. Kothari RU, Pancioli A, Liu T, et al. Cincinnati prehospital stroke scale: reproducibility and validity. Ann Emerg Med. 1999;33(4):373–8.

    Article  CAS  PubMed  Google Scholar 

  27. Kidwell CS, Starkman S, Eckstein M, et al. Identifying stroke in the field. Prospective validation of the Los Angeles prehospital stroke screen (LAPSS). Stroke. 2000;31(1):71–6.

    Article  CAS  PubMed  Google Scholar 

  28. Harbison J, Massey A, Barnett L, et al. Rapid ambulance protocol for acute stroke. Lancet. 1999;353(9168):1935.

    Article  CAS  PubMed  Google Scholar 

  29. Goldstein LB. Simel DL. Is this patient having a stroke? JAMA. 2005;293:2391–402.

    Article  CAS  PubMed  Google Scholar 

  30. Jauch EC, Cucchiara B, Adeoye O, et al. Part 11: adult stroke: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 Suppl 3):S818–28.

    Article  PubMed  Google Scholar 

  31. Peberdy MA, Callaway CW, Neumar RW, et al. Part 9: post-cardiac arrest care: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 Suppl 3):S768–86.

    Article  PubMed  Google Scholar 

  32. Walter S, Kostpopoulos P, Haass A, et al. Bringing the hospital to the patient: first treatment of stroke patients at the emergency site. PLoS One. 2010;5(10):e13758.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Hiyama N, Yoshimura S, Shirakawa M, et al. Safety and effectiveness of drip, ship, and retrieve paradigm for acute ischemic stroke: a single center experience. Neurol Med Chir (Tokyo). 2016;56(12):731–6. Epub 2016 Jul 14

    Article  Google Scholar 

  34. Kageji T, Obata F, Oka H, et al. Drip-and-ship thrombolytic therapy supported by the Telestroke system for acute ischemic stroke patients living in medically under-served areas. Neurol Med Chir (Tokyo). 2016;56(12):753–8. Epub 2016 Jun 22

    Article  Google Scholar 

  35. Walter S, Kostopoulos P, Haass A, et al. Diagnosis and treatment of patients with stroke in a mobile stroke unit versus in hospital: a randomised controlled trial. Lancet Neurol. 2012;11(5):397–404.

    Article  PubMed  Google Scholar 

  36. Weber JE, Ebinger M, Rozanski M, et al. Prehospital thrombolysis in acute stroke: results of the PHANTOM-S pilot study. Neurology. 2013;80(2):163–8.

    Article  CAS  PubMed  Google Scholar 

  37. Ebinger M, Kunz A, Wendt M, et al. Effects of golden hour thrombolysis: a prehospital acute neurological treatment and optimization of medical Care in Stroke (PHANTOM-S) substudy. JAMA Neurol. 2015;72(1):25–30.

    Article  PubMed  Google Scholar 

  38. Gierhake D, Weber JE, Villringer K, et al. [Mobile CT: technical aspects of prehospital stroke imaging before intravenous thrombolysis]. [Article in German]. Rofo. 2013;185(1):55–9.

    PubMed  CAS  Google Scholar 

  39. Frontera JA, Lewin JJ, Rabinstein AA, et al. Guideline for reversal of antithrombotics in intracranial hemorrhage: executive summary, a statement for healthcare professionals from the Neurocritical care society and Society of Critical Care Medicine. Crit Care Med. 2016;44:2251–7.

    Article  PubMed  Google Scholar 

  40. Gomes JA, Ahrens CL, Hussain MS, et al. Prehospital reversal of warfarin-related coagulopathy in intracerebral hemorrhage in a mobile stroke treatment unit. Stroke. 2015;46(5):e118–20.

    Article  PubMed  Google Scholar 

  41. Bowry R, Parker S, Rajan SS, et al. Benefits of stroke treatment using a mobile stroke unit compared with standard management: the BEST-MSU study run-in phase. Stroke. 2015;46(12):3370–4.

    Article  CAS  PubMed  Google Scholar 

  42. Al Kasab S, Adams RJ, Debenham E, et al. Medical University of South Carolina Telestroke: a telemedicine facilitated network for stroke treatment in South Carolina-a progress report. Telemed J E Health. 2017;23:674.

    Article  PubMed  Google Scholar 

  43. Wechsler LR, Demaerschalk BM, Schwamm LH, et al. Telemedicine quality and outcomes in stroke: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2017;48(1):e3–e25.

    Article  PubMed  Google Scholar 

  44. Kim J-T, Fonarow GC, Smith EE, et al. Treatment with tissue plasminogen activator in the golden hour and the shape of the 4.5-hour time-benefit curve in the national United States Get With The Guidelines–Stroke population. Circulation. 2017;135:128–39.

    Article  CAS  PubMed  Google Scholar 

  45. Prabhakaran S, O’Neill K, Stein-Spencer L, Walter J, Alberts MJ. Prehospital triage to primary stroke centers and rate of stroke thrombolysis. JAMA Neurol. 2013;70:1126–32.

    Article  PubMed  Google Scholar 

  46. Ikram MA, Wieberdink RG, Koudstaal PJ. International epidemiology of intracerebral hemorrhage. Curr Atheroscler Rep. 2012;14(4):300–6.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Qureshi AI, Mendelow AD, Hanley DF. Intracerebral haemorrhage. Lancet. 2009;373(9675):1632–44.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Hwang BY, Appelboom G, Kellner CP, et al. Clinical grading scales in intracerebral hemorrhage. Neurocrit Care. 2010;13:141–51.

    Article  PubMed  Google Scholar 

  49. Wang W, Lu J, Wang C, et al. Prognostic value of ICH score and ICH-GS score in Chinese intracerebral hemorrhage patients: analysis from the China National Stroke Registry (CNSR). PLoS One. 2013;8(10):e77421.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Macellari F, Paciaroni M, Agnelli G, et al. Neuroimaging in intracerebral hemorrhage. Stroke. 2014;45(3):903–8.

    Article  PubMed  Google Scholar 

  51. Halpin SF, Britton JA, Byrne JV, et al. Prospective evaluation of cerebral angiography and computed tomography in cerebral haematoma. J Neurol Neurosurg Psychiatry. 1994;57(10):1180–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Wijman CA, Venkatasubramanian C, Bruins S, et al. Utility of early MRI in the diagnosis and management of acute spontaneous intracerebral hemorrhage. Cerebrovasc Dis. 2010;30(5):456–63.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Demchuk AM, Dowlatshahi D, Rodriguez-Luna D, et al. Prediction of haematoma growth and outcome in patients with intracerebral haemorrhage using the CT-angiography spot sign (PREDICT): a prospective observational study. Lancet Neurol. 2012;11(4):307–14.

    Article  PubMed  Google Scholar 

  54. Brouwers HB, Chang Y, Falcone GJ, et al. Predicting hematoma expansion after primary intracerebral hemorrhage. JAMA Neurol. 2014;71(2):158–64.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Earnest F 4th, Baker HL Jr, Kispert DB, Laws ER Jr. Magnetic resonance imaging vs. computed tomography: advantages and disadvantages. Clin Neurosurg. 1985;32:540–73.

    PubMed  Google Scholar 

  56. Ohtani R, Kazui S, Tomimoto H, et al. Clinical and radiographic features of lobar cerebral hemorrhage: hypertensive versus non-hypertensive cases. Intern Med. 2003;42(7):576–80.

    Article  PubMed  Google Scholar 

  57. Meretoja A, Churilov L, Campbell BC, et al. The spot sign and tranexamic acid on preventing ICH growth--AUStralasia trial (STOP-AUST): protocol of a phase II randomized, placebo-controlled, double-blind, multicenter trial. Int J Stroke. 2014;9(4):519–24.

    Article  PubMed  Google Scholar 

  58. Liu L, Wang Y, Meng X, et al. Tranexamic acid for acute intracerebral hemorrhage growth predicted by spot sign trial: rationale and design. Int J Stroke. 2017;12(3):326–31.

    Article  PubMed  Google Scholar 

  59. Rehmani R, Han A, Hassan J, et al. Role of prothrombin complex concentrate (PCC) in acute intracerebral hemorrhage with positive CTA spot sign: an institutional experience at a regional and state designated stroke center. Emerg Radiol. 2016;24(3):241.

    Article  PubMed  Google Scholar 

  60. Morotti A, Romero JM, Jessel MJ, et al. Effect of CTA tube current on spot sign detection and accuracy for prediction of intracerebral hemorrhage expansion. AJNR Am J Neuroradiol. 2016;37:1781.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Boulouis G, van Etten ES, Charidimou A, et al. Association of key Magnetic Resonance Imaging Markers of cerebral small vessel disease with hematoma volume and expansion in patients with lobar and deep intracerebral hemorrhage. JAMA Neurol. 2016;73(12):1440–7.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Salhi B, Stettner E. In defense of the use of lidocaine in rapid sequence intubation. Ann Emerg Med. 2007;49(1):84–6.

    Article  PubMed  Google Scholar 

  63. Zheng H, Chen C, Zhang J, et al. Mechanism and therapy of brain edema after intracerebral hemorrhage. Cerebrovasc Dis. 2016;42(3–4):155–69.

    Article  PubMed  Google Scholar 

  64. Manning LS, Robinson TG. New insights into blood pressure control for intracerebral Haemorrhage. Front Neurol Neurosci. 2015;37:35–50.

    Article  PubMed  Google Scholar 

  65. Qureshi AI, Palesch YY, Martin R, et al. Effect of systolic blood pressure reduction on hematoma expansion, perihematomal edema, and 3-month outcome among patients with intracerebral hemorrhage: results from the antihypertensive treatment of acute cerebral hemorrhage study. Arch Neurol. 2010;67(5):570–6.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Anderson CS, Huang Y, Wang JG, et al. Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial. Lancet Neurol. 2008;7:391–9.

    Article  PubMed  Google Scholar 

  67. Delcourt C, Huang Y, Wang J, et al. The second (main) phase of an open, randomised, multicentre study to investigate the effectiveness of an intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT2). Int J Stroke. 2010;5:110–6.

    Article  CAS  PubMed  Google Scholar 

  68. Anderson CS, Heeley E, Huang Y, et al. Rapid blood-pressure lowering in patients with acute intracerebral hemorrhage. N Engl J Med. 2013;368:2355–65.

    Article  CAS  PubMed  Google Scholar 

  69. Anderson C, Heeley E, Heritier S, et al. Statistical analysis plan for the second INTEnsive blood pressure reduction in acute cerebral hemorrhage trial (INTERACT2): a large-scale investigation to solve longstanding controversy over the most appropriate management of elevated blood pressure in the hyperacute phase of intracerebral hemorrhage. Int J Stroke. 2013;8:327–8.

    Article  PubMed  Google Scholar 

  70. Qureshi AI, Palesch YY, Barsan WG, et al. Intensive blood-pressure lowering in patients with acute cerebral hemorrhage. N Engl J Med. 2016;375(11):1033–43.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Graffagnino C, Bergese S, Love J, et al. Clevidipine rapidly and safely reduces blood pressure in acute intracerebral hemorrhage: the ACCELERATE trial. Cerebrovasc Dis. 2013;36(3):173–80.

    Article  CAS  PubMed  Google Scholar 

  72. Hunt BJ. Bleeding and coagulopathies in critical care. N Engl J Med. 2014;370(9):847–59.

    Article  CAS  PubMed  Google Scholar 

  73. Aguilar MI, Freeman WD. Treatment of coagulopathy in intracranial hemorrhage. Curr Treat Options Neurol. 2010;12(2):113–28.

    Article  PubMed  Google Scholar 

  74. Milling TJ, Refaai MA, Goldstein JN, et al. Thromboembolic events after vitamin K antagonist reversal with 4-factor prothrombin complex concentrate: exploratory analyses of two randomized, plasma-controlled studies. Ann Emerg Med. 2016;67(1):96–105.e5.

    Article  PubMed  Google Scholar 

  75. Baharoglu MI, Cordonnier C, Al-Shahi Salman R, et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet. 2016;387(10038):2605–13.

    Article  PubMed  Google Scholar 

  76. Steiner T, Poli S, Griebe M, et al. Fresh frozen plasma versus prothrombin complex concentrate in patients with intracranial haemorrhage related to vitamin K antagonists (INCH): a randomised trial. Lancet Neurol. 2016;15(6):566–73.

    Article  CAS  PubMed  Google Scholar 

  77. Goldstein JN, Refaai MA, Milling TJ Jr, et al. Four-factor prothrombin complex concentrate versus plasma for rapid vitamin K antagonist reversal in patients needing urgent surgical or invasive interventions: a phase 3b, open-label, noninferiority, randomised trial. Lancet. 2015;6736(14):1–11.

    Google Scholar 

  78. Mayer SA, Brun NC, Begtrup K, et al. Efficacy and safety of recombinant activated factor VII for acute intracerebral hemorrhage. N Engl J Med. 2008;358(20):2127–37.

    Article  CAS  PubMed  Google Scholar 

  79. Kaatz S, Kouides PA, Garcia DA, et al. Guidance on the emergent reversal of oral thrombin and factor Xa inhibitors. Am J Hematol. 2012;87(Suppl 1):141–5.

    Article  CAS  Google Scholar 

  80. Steiner T, Bo¨hm M, Dichgans M, et al. Recommendations for the emergency management of complications associated with the new direct oral anticoagulants (DOACs), apixaban, dabigatran and rivaroxaban. Clin Res Cardiol. 2013;102(6):399–412.

    Article  CAS  PubMed  Google Scholar 

  81. Held V, Eisele P, Eschenfelder CC, et al. Idarucizumab as antidote to intracerebral hemorrhage under treatment with dabigatran. Case Rep Neurol. 2016;8(3):224–8.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Nafee T, Aslam A, Chi G, et al. Andexanet alfa for the reversal of anticoagulant activity in patients treated with direct and indirect factor Xa inhibitors. Expert Rev Cardiovasc Ther. 2017;15(4):237–45.

    Article  CAS  PubMed  Google Scholar 

  83. da Luz LT, Marchand M, Nascimento B, et al. Efficacy and safety of the drugs used to reverse direct oral anticoagulants: a systematic review and meta-analysis. Transfusion. 2017;57:1834. https://doi.org/10.1111/trf.14096.

    Article  PubMed  Google Scholar 

  84. Hunt BJ, Levi M. Andexanet alfa for factor Xa inhibitor reversal. N Engl J Med. 2016;375(25):2500.

    Article  PubMed  Google Scholar 

  85. Yaghi S, Eisenberger A, Willey JZ. Symptomatic intracerebral hemorrhage in acute ischemic stroke after thrombolysis with intravenous recombinant tissue plasminogen activator: a review of natural history and treatment. JAMA Neurol. 2014;71(9):1181–5.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Mendelow AD, Gregson BA, Fernandes HM, et al. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trial. Lancet. 2005;365:387–97.

    Article  PubMed  Google Scholar 

  87. Mendelow AD, Gregson BA, Mitchell PM, et al. Surgical trial in lobar intracerebral Haemorrhage (STICH II) protocol. Trials. 2011;12:124. https://doi.org/10.1186/1745-6215-12-124.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Fung C, Murek M, Z’Graggen WJ, et al. Decompressive hemicraniectomy in patients with supratentorial intracerebral hemorrhage. Stroke. 2012;43:3207–11. https://doi.org/10.1161/STROKEAHA.112.666537.

    Article  PubMed  Google Scholar 

  89. Takeuchi S, Wada K, Nagatani K, Otani N, Mori K. Decompressive hemicraniectomy for spontaneous intracerebral hemorrhage. Neurosurg Focus. 2013;34:E5. https://doi.org/10.3171/2013.2.FOCUS12424.

    Article  PubMed  Google Scholar 

  90. Morgan T, Zuccarello M, Narayan R, Keyl P, Lane K, Hanley D. Preliminary findings of the minimally-invasive surgery plus rtPA for intracerebral hemorrhage evacuation (MISTIE) clinical trial. Acta Neurochir Suppl. 2008;105:147–51.

    Article  CAS  PubMed  Google Scholar 

  91. Spiotta AM, Fiorella D, Vargas J, et al. Initial multicenter technical experience with the Apollo device for minimally invasive intracerebral hematoma evacuation. Neurosurgery. 2015;11(Suppl 2):243–51.; discussion 251. https://doi.org/10.1227/NEU.0000000000000698.

    Article  PubMed  Google Scholar 

  92. Yadav YR, Mukerji G, Shenoy R, Basoor A, Jain G, Nelson A. Endoscopic management of hypertensive intraventricular haemorrhage with obstructive hydrocephalus. BMC Neurol. 2007;7:1. https://doi.org/10.1186/1471-2377-7-1.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Middleton S, McElduff P, Ward J, et al. Implementation of evidence-based treatment protocols to manage fever, hyperglycaemia, and swallowing dysfunction in acute stroke (QASC): a cluster randomised controlled trial. Lancet. 2011;378(9804):1699–706.

    Article  PubMed  Google Scholar 

  94. De Herdt V, Dumont F, He’non H, et al. Early seizures in intracerebral hemorrhage: incidence, associated factors and outcome. Neurology. 2011;77(20):1794–800.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA

    Muhammad Fawad Ishfaq, Nitin Goyal, Abhi Pandhi & Marc Malkoff

Authors
  1. Muhammad Fawad Ishfaq
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nitin Goyal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abhi Pandhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marc Malkoff
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marc Malkoff .

Editor information

Editors and Affiliations

  1. University of California, San Francisco Medical Center, San Francisco, CA, USA

    Bruce Ovbiagele

  2. University of Minnesota, Minneapolis, MN, USA

    Adnan I. Qureshi

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ishfaq, M.F., Goyal, N., Pandhi, A., Malkoff, M. (2018). Prehospital and Emergency Department Management of Intracerebral Hemorrhage. In: Ovbiagele, B., Qureshi, A. (eds) Intracerebral Hemorrhage Therapeutics. Springer, Cham. https://doi.org/10.1007/978-3-319-77063-5_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-77063-5_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-77062-8

  • Online ISBN: 978-3-319-77063-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation