Translational Stroke Research

, Volume 3, Supplement 1, pp 10–24

Intracerebral Hemorrhage: Clinical Overview and Pathophysiologic Concepts

Review Article

Abstract

Intracerebral hemorrhage is by far the most destructive form of stroke. Apart from the management in a specialized stroke or neurological intensive care unit (NICU), no specific therapies have been shown to consistently improve outcomes after ICH. Current guidelines endorse early aggressive optimization of physiologic derangements with ventilatory support when indicated, blood pressure control, reversal of any preexisting coagulopathy, intracranial pressure monitoring for certain cases, osmotherapy, temperature modulation, seizure prophylaxis, treatment of hyerglycemia, and nutritional support in the stroke unit or NICU. Ventriculostomy is the cornerstone of therapy for control of intracranial pressure patients with intraventricular hemorrhage. Surgical hematoma evacuation does not improve outcome for more patients, but is a reasonable option for patients with early worsening due to mass effect due to large cerebellar or lobar hemorrhages. Promising experimental treatments currently include ultra-early hemostatic therapy, intraventricular clot lysis with thrombolytics, pioglitazone, temperature modulation, and deferoxamine to reduce iron-mediated perihematomal inflammation and tissue injury.

Keywords

Stroke Hypertension Cerebral edema Intracranial pressure Neurological intensive care Intensive care Neurocritical care 

References

  1. 1.
    Hanley DF. Intraventricular hemorrhage: severity factor and treatment target in spontaneous intracerebral hemorrhage. Stroke. 2009;40(4):1533–8. doi:10.1161/STROKEAHA.108.535419.PubMedCrossRefGoogle Scholar
  2. 2.
    Sacco RL, Mayer SA. Epidemiology of intracerebral hemorrhage. In: Feldmann E, editor. Intracerebral hemorrhage. Armonk: Futura Publishing Co; 1994. p. 3–23.Google Scholar
  3. 3.
    Woo D, Broderick JP. Spontaneous intracerebral hemorrhage: epidemiology and clinical presentation. Neurosurg Clin N Am. 2002;13(3):265–79. v.PubMedCrossRefGoogle Scholar
  4. 4.
    Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM, et al. Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation. 2011;123(4):e18–e209. doi:10.1161/CIR.0b013e3182009701.PubMedCrossRefGoogle Scholar
  5. 5.
    Broderick JP, Brott T, Tomsick T, Miller R, Huster G. Intracerebral hemorrhage more than twice as common as subarachnoid hemorrhage. J Neurosurg. 1993;78(2):188–91.PubMedCrossRefGoogle Scholar
  6. 6.
    Rincon F, Mayer SA. Current treatment options for intracerebral hemorrhage. Curr Treat Options Cardiovasc Med. 2008;10(3):229–40.PubMedCrossRefGoogle Scholar
  7. 7.
    Flaherty ML. Anticoagulant-associated intracerebral hemorrhage. Sem Neurol. 2010;30(5):565–72. doi:10.1055/s-0030-1268866.CrossRefGoogle Scholar
  8. 8.
    Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF. Spontaneous intracerebral hemorrhage. N Engl J Med. 2001;344(19):1450–60.PubMedCrossRefGoogle Scholar
  9. 9.
    Skidmore CT, Andrefsky J. Spontaneous intracerebral hemorrhage: epidemiology, pathophysiology, and medical management. Neurosurg Clin N Am. 2002;13(3):281–8. v.PubMedCrossRefGoogle Scholar
  10. 10.
    Siddique MS, Gregson BA, Fernandes HM, Barnes J, Treadwell L, Wooldridge TD, et al. Comparative study of traumatic and spontaneous intracerebral hemorrhage. J Neurosurg. 2002;96(1):86–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Arboix A, Vall-Llosera A, Garcia-Eroles L, Massons J, Oliveres M, Targa C. Clinical features and functional outcome of intracerebral hemorrhage in patients aged 85 and older. J Am Geriatr Soc. 2002;50(3):449–54.PubMedCrossRefGoogle Scholar
  12. 12.
    Qureshi AI, Mohammad Y, Suri MF, Braimah J, Janardhan V, Guterman LR, et al. Cocaine use and hypertension are major risk factors for intracerebral hemorrhage in young African Americans. Ethn Dis. 2001;11(2):311–9.PubMedGoogle Scholar
  13. 13.
    Tanaka H, Ueda Y, Hayashi M, Date C, Baba T, Yamashita H, et al. Risk factors for cerebral hemorrhage and cerebral infarction in a Japanese rural community. Stroke. 1982;13(1):62–73.PubMedCrossRefGoogle Scholar
  14. 14.
    Ariesen MJ, Claus SP, Rinkel GJ, Algra A. Risk factors for intracerebral hemorrhage in the general population: a systematic review. Stroke. 2003;34(8):2060–5.PubMedCrossRefGoogle Scholar
  15. 15.
    Saloheimo P, Juvela S, Hillbom M. Use of aspirin, epistaxis, and untreated hypertension as risk factors for primary intracerebral hemorrhage in middle-aged and elderly people. Stroke. 2001;32(2):399–404.PubMedCrossRefGoogle Scholar
  16. 16.
    Johnsen SP, Pedersen L, Friis S, Blot WJ, McLaughlin JK, Olsen JH, et al. Nonaspirin nonsteroidal anti-inflammatory drugs and risk of hospitalization for intracerebral hemorrhage: a population-based case-control study. Stroke. 2003;34(2):387–91.PubMedCrossRefGoogle Scholar
  17. 17.
    Bak S, Andersen M, Tsiropoulos I, Garcia Rodriguez LA, Hallas J, Christensen K, et al. Risk of stroke associated with nonsteroidal anti-inflammatory drugs: a nested case-control study. Stroke. 2003;34(2):379–86.PubMedCrossRefGoogle Scholar
  18. 18.
    Rincon F, Mayer SA. Novel therapies for intracerebral hemorrhage. Curr Opin Crit Care. 2004;10(2):94–100.PubMedCrossRefGoogle Scholar
  19. 19.
    Brott T, Thalinger K, Hertzberg V. Hypertension as a risk factor for spontaneous intracerebral hemorrhage. Stroke. 1986;17(6):1078–83.PubMedCrossRefGoogle Scholar
  20. 20.
    Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF. Spontaneous intracerebral hemorrhage. N Engl J Med. 2001;344(19):1450–60. doi:10.1056/NEJM200105103441907.PubMedCrossRefGoogle Scholar
  21. 21.
    Kase CS, Williams JP, Wyatt DA, Mohr JP. Lobar intracerebral hematomas: clinical and CT analysis of 22 cases. Neurology. 1982;32(10):1146–50.PubMedCrossRefGoogle Scholar
  22. 22.
    Felberg RA, Grotta JC, Shirzadi AL, Strong R, Narayana P, Hill-Felberg SJ, et al. Cell death in experimental intracerebral hemorrhage: the “black hole” model of hemorrhagic damage. Ann Neurol. 2002;51(4):517–24.PubMedCrossRefGoogle Scholar
  23. 23.
    Qureshi AI, Ali Z, Suri MF, Shuaib A, Baker G, Todd K, et al. Extracellular glutamate and other amino acids in experimental intracerebral hemorrhage: an in vivo microdialysis study. Crit Care Med. 2003;31(5):1482–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Power C, Henry S, Del Bigio MR, Larsen PH, Corbett D, Imai Y, et al. Intracerebral hemorrhage induces macrophage activation and matrix metalloproteinases. Ann Neurol. 2003;53(6):731–42.PubMedCrossRefGoogle Scholar
  25. 25.
    Mayer SA. Ultra-early hemostatic therapy for intracerebral hemorrhage. Stroke. 2003;34(1):224–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Gebel Jr JM, Jauch EC, Brott TG, Khoury J, Sauerbeck L, Salisbury S, et al. Relative edema volume is a predictor of outcome in patients with hyperacute spontaneous intracerebral hemorrhage. Stroke. 2002;33(11):2636–41.PubMedCrossRefGoogle Scholar
  27. 27.
    Cheung RT, Zou LY. Use of the original, modified, or new intracerebral hemorrhage score to predict mortality and morbidity after intracerebral hemorrhage. Stroke. 2003;34(7):1717–22.PubMedCrossRefGoogle Scholar
  28. 28.
    Hemphill 3rd JC, Bonovich DC, Besmertis L, Manley GT, Johnston SC. The ICH score: a simple, reliable grading scale for intracerebral hemorrhage. Stroke. 2001;32(4):891–7.PubMedCrossRefGoogle Scholar
  29. 29.
    Mayer SA, Lignelli A, Fink ME, Kessler DB, Thomas CE, Swarup R, et al. Perilesional blood flow and edema formation in acute intracerebral hemorrhage: a SPECT study. Stroke. 1998;29(9):1791–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Becker KJ, Baxter AB, Bybee HM, Tirschwell DL, Abouelsaad T, Cohen WA. Extravasation of radiographic contrast is an independent predictor of death in primary intracerebral hemorrhage. Stroke. 1999;30(10):2025–32.PubMedCrossRefGoogle Scholar
  31. 31.
    Gordon CR, Merchant RS, Marmarou A, Rice CD, Marsh JT, Young HF. Effect of murine recombinant interleukin-1 on brain oedema in the rat. Acta Neurochir Suppl (Wien). 1990;51:268–70.Google Scholar
  32. 32.
    Megyeri P, Abraham CS, Temesvari P, Kovacs J, Vas T, Speer CP. Recombinant human tumor necrosis factor alpha constricts pial arterioles and increases blood-brain barrier permeability in newborn piglets. Neurosci Lett. 1992;148(1–2):137–40.PubMedCrossRefGoogle Scholar
  33. 33.
    Marti-Fabregas J, Borrell M, Silva Y, Delgado-Mederos R, Martinez-Ramirez S, de Juan-Delago M, et al. Hemostatic proteins and their association with hematoma growth in patients with acute intracerebral hemorrhage. Stroke J Cereb Circ. 2010;41(12):2976–8. doi:10.1161/STROKEAHA.110.595868.CrossRefGoogle Scholar
  34. 34.
    Takahashi H, Urano T, Nagai N, Takada Y, Takada A. Progressive expansion of hypertensive intracerebral hemorrhage by coagulopathy. Am J Hematol. 1998;59(2):110–4.PubMedCrossRefGoogle Scholar
  35. 35.
    Olivot JM, Mlynash M, Kleinman JT, Straka M, Venkatasubramanian C, Bammer R, et al. MRI profile of the perihematomal region in acute intracerebral hemorrhage. Stroke. 2010;41(11):2681–3. doi:10.1161/STROKEAHA.110.590638.PubMedCrossRefGoogle Scholar
  36. 36.
    Siddique MS, Fernandes HM, Wooldridge TD, Fenwick JD, Slomka P, Mendelow AD. Reversible ischemia around intracerebral hemorrhage: a single-photon emission computerized tomography study. J Neurosurg. 2002;96(4):736–41.PubMedCrossRefGoogle Scholar
  37. 37.
    Rosand J, Eskey C, Chang Y, Gonzalez RG, Greenberg SM, Koroshetz WJ. Dynamic single-section CT demonstrates reduced cerebral blood flow in acute intracerebral hemorrhage. Cerebrovasc Dis. 2002;14(3–4):214–20.PubMedCrossRefGoogle Scholar
  38. 38.
    Zazulia AR, Diringer MN, Videen TO, Adams RE, Yundt K, Aiyagari V, et al. Hypoperfusion without ischemia surrounding acute intracerebral hemorrhage. J Cereb Blood Flow Metab. 2001;21(7):804–10.PubMedCrossRefGoogle Scholar
  39. 39.
    Schellinger PD, Fiebach JB, Hoffmann K, Becker K, Orakcioglu B, Kollmar R, et al. Stroke MRI in intracerebral hemorrhage: is there a perihemorrhagic penumbra? Stroke. 2003;34(7):1674–9.PubMedCrossRefGoogle Scholar
  40. 40.
    Rohde V, Rohde I, Thiex R, Ince A, Jung A, Duckers G, et al. Fibrinolysis therapy achieved with tissue plasminogen activator and aspiration of the liquefied clot after experimental intracerebral hemorrhage: rapid reduction in hematoma volume but intensification of delayed edema formation. J Neurosurg. 2002;97(4):954–62.PubMedCrossRefGoogle Scholar
  41. 41.
    Sansing LH, Kaznatcheeva EA, Perkins CJ, Komaroff E, Gutman FB, Newman GC. Edema after intracerebral hemorrhage: correlations with coagulation parameters and treatment. J Neurosurg. 2003;98(5):985–92.PubMedCrossRefGoogle Scholar
  42. 42.
    Abilleira S, Montaner J, Molina CA, Monasterio J, Castillo J, Alvarez-Sabin J. Matrix metalloproteinase-9 concentration after spontaneous intracerebral hemorrhage. J Neurosurg. 2003;99(1):65–70.PubMedCrossRefGoogle Scholar
  43. 43.
    Hua Y, Xi G, Keep RF, Wu J, Jiang Y, Hoff JT. Plasminogen activator inhibitor-1 induction after experimental intracerebral hemorrhage. J Cereb Blood Flow Metab. 2002;22(1):55–61.PubMedCrossRefGoogle Scholar
  44. 44.
    Huang FP, Xi G, Keep RF, Hua Y, Nemoianu A, Hoff JT. Brain edema after experimental intracerebral hemorrhage: role of hemoglobin degradation products. J Neurosurg. 2002;96(2):287–93.PubMedCrossRefGoogle Scholar
  45. 45.
    Xi G, Wagner KR, Keep RF, Hua Y, de Courten-Myers GM, Broderick JP, et al. Role of blood clot formation on early edema development after experimental intracerebral hemorrhage. Stroke. 1998;29(12):2580–6.PubMedCrossRefGoogle Scholar
  46. 46.
    Wagner KR, Xi G, Hua Y, Kleinholz M, de Courten-Myers GM, Myers RE, et al. Lobar intracerebral hemorrhage model in pigs: rapid edema development in perihematomal white matter. Stroke. 1996;27(3):490–7.PubMedCrossRefGoogle Scholar
  47. 47.
    Kitaoka T, Hua Y, Xi G, Hoff JT, Keep RF. Delayed argatroban treatment reduces edema in a rat model of intracerebral hemorrhage. Stroke. 2002;33(12):3012–8.PubMedCrossRefGoogle Scholar
  48. 48.
    Lee KR, Kawai N, Kim S, Sagher O, Hoff JT. Mechanisms of edema formation after intracerebral hemorrhage: effects of thrombin on cerebral blood flow, blood-brain barrier permeability, and cell survival in a rat model. J Neurosurg. 1997;86(2):272–8.PubMedCrossRefGoogle Scholar
  49. 49.
    Dziedzic T, Bartus S, Klimkowicz A, Motyl M, Slowik A, Szczudlik A. Intracerebral hemorrhage triggers interleukin-6 and interleukin-10 release in blood. Stroke. 2002;33(9):2334–5.PubMedCrossRefGoogle Scholar
  50. 50.
    Castillo J, Davalos A, Alvarez-Sabin J, Pumar JM, Leira R, Silva Y, et al. Molecular signatures of brain injury after intracerebral hemorrhage. Neurology. 2002;58(4):624–9.PubMedCrossRefGoogle Scholar
  51. 51.
    Ducruet AF, Zacharia BE, Hickman ZL, Grobelny BT, Yeh ML, Sosunov SA, et al. The complement cascade as a therapeutic target in intracerebral hemorrhage. Exp Neurol. 2009;219(2):398–403. doi:10.1016/j.expneurol.2009.07.018.PubMedCrossRefGoogle Scholar
  52. 52.
    Xi G, Hua Y, Keep RF, Younger JG, Hoff JT. Brain edema after intracerebral hemorrhage: the effects of systemic complement depletion. Acta Neurochir Suppl. 2002;81:253–6.PubMedGoogle Scholar
  53. 53.
    Song EC, Chu K, Jeong SW, Jung KH, Kim SH, Kim M, et al. Hyperglycemia exacerbates brain edema and perihematomal cell death after intracerebral hemorrhage. Stroke. 2003;34(9):2215–20.PubMedCrossRefGoogle Scholar
  54. 54.
    Grossetete M, Rosenberg GA. Matrix metalloproteinase inhibition facilitates cell death in intracerebral hemorrhage in mouse. J Cereb Blood Flow Metab. 2008;28(4):752–63. doi:10.1038/sj.jcbfm.9600572.PubMedCrossRefGoogle Scholar
  55. 55.
    Rosenberg GA, Navratil M. Metalloproteinase inhibition blocks edema in intracerebral hemorrhage in the rat. Neurology. 1997;48(4):921–6.PubMedCrossRefGoogle Scholar
  56. 56.
    Gu Z, Kaul M, Yan B, Kridel SJ, Cui J, Strongin A, et al. S-nitrosylation of matrix metalloproteinases: signaling pathway to neuronal cell death. Science. 2002;297(5584):1186–90. doi:10.1126/science.1073634.PubMedCrossRefGoogle Scholar
  57. 57.
    Grossetete M, Rosenberg GA. Tissue inhibitor of matrix metalloproteinases-3 (TIMP-3) lacks involvement in bacterial collagenase-induced intracerebral hemorrhage in mouse. Acta Neurochir Suppl. 2008;105:89–93.PubMedCrossRefGoogle Scholar
  58. 58.
    Qureshi AI, Ezzeddine MA, Nasar A, Suri MF, Kirmani JF, Hussein HM, et al. Prevalence of elevated blood pressure in 563,704 adult patients with stroke presenting to the ED in the United States. Am J Emerg Med. 2007;25(1):32–8. doi:10.1016/j.ajem.2006.07.008.PubMedCrossRefGoogle Scholar
  59. 59.
    Mayer SA, Kurtz P, Wyman A, Sung GY, Multz AS, Varon J, et al. Clinical practices, complications, and mortality in neurological patients with acute severe hypertension: the Studying the Treatment of Acute hyperTension (STAT) registry. Crit Care Med. 2011. doi:10.1097/CCM.0b013e3182227238.
  60. 60.
    Rose JC, Mayer SA. Optimizing blood pressure in neurological emergencies. Neurocrit Care. 2004;1(3):287–99.PubMedCrossRefGoogle Scholar
  61. 61.
    Dandapani BK, Suzuki S, Kelley RE, Reyes-Iglesias Y, Duncan RC. Relation between blood pressure and outcome in intracerebral hemorrhage. Stroke J Cereb Circ. 1995;26(1):21–4.CrossRefGoogle Scholar
  62. 62.
    Fogelholm R, Avikainen S, Murros K. Prognostic value and determinants of first-day mean arterial pressure in spontaneous supratentorial intracerebral hemorrhage. Stroke J Cereb Circ. 1997;28(7):1396–400.CrossRefGoogle Scholar
  63. 63.
    Terayama Y, Tanahashi N, Fukuuchi Y, Gotoh F. Prognostic value of admission blood pressure in patients with intracerebral hemorrhage. Keio Cooperative Stroke Study. Stroke J Cereb Circ. 1997;28(6):1185–8.CrossRefGoogle Scholar
  64. 64.
    Willmot M, Leonardi-Bee J, Bath PM. High blood pressure in acute stroke and subsequent outcome: a systematic review. Hypertension. 2004;43(1):18–24. doi:10.1161/01.HYP.0000105052.65787.35.PubMedCrossRefGoogle Scholar
  65. 65.
    Zhang Y, Reilly KH, Tong W, Xu T, Chen J, Bazzano LA, et al. Blood pressure and clinical outcome among patients with acute stroke in Inner Mongolia, China. J Hypertens. 2008;26(7):1446–52. doi:10.1097/HJH.0b013e328300a24a.PubMedCrossRefGoogle Scholar
  66. 66.
    Brott T, Broderick J, Kothari R, Barsan W, Tomsick T, Sauerbeck L, et al. Early hemorrhage growth in patients with intracerebral hemorrhage. Stroke. 1997;28(1):1–5.PubMedCrossRefGoogle Scholar
  67. 67.
    Broderick JP, Diringer MN, Hill MD, Brun NC, Mayer SA, Steiner T, et al. Determinants of intracerebral hemorrhage growth: an exploratory analysis. Stroke. 2007;38(3):1072–5.PubMedCrossRefGoogle Scholar
  68. 68.
    Powers WJ, Zazulia AR, Videen TO, Adams RE, Yundt KD, Aiyagari V, et al. Autoregulation of cerebral blood flow surrounding acute (6 to 22 hours) intracerebral hemorrhage. Neurology. 2001;57(1):18–24.PubMedCrossRefGoogle Scholar
  69. 69.
    Powers WJ, Adams RE, Yundt KD. Acute pharmacological hypotension after intracerebral hemorrhage does not change cerebral blood flow. Stroke. 1999;30:242.Google Scholar
  70. 70.
    Qureshi AI, Wilson DA, Hanley DF, Traystman RJ. Pharmacologic reduction of mean arterial pressure does not adversely affect regional cerebral blood flow and intracranial pressure in experimental intracerebral hemorrhage. Crit Care Med. 1999;27(5):965–71.PubMedCrossRefGoogle Scholar
  71. 71.
    Anderson CS, Huang Y, Wang JG, Arima H, Neal B, Peng B, et al. Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial. Lancet Neurol. 2008;7(5):391–9. doi:S1474-4422(08)70069-3 [pii]10.1016/S1474-4422(08)70069-3.PubMedCrossRefGoogle Scholar
  72. 72.
    Qureshi AI. Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH): rationale and design. Neurocrit Care. 2007;6(1):56–66. doi:NCC:6:1:56 [pii].PubMedCrossRefGoogle Scholar
  73. 73.
    Qureshi AI, Palesch YY, Martin R, Novitzke J, Cruz-Flores S, Ehtisham A, 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. doi:67/5/570 [pii]10.1001/archneurol.2010.61.PubMedCrossRefGoogle Scholar
  74. 74.
    Broderick J, Connolly S, Feldmann E, Hanley D, Kase C, Krieger D, et al. Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: a guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group. Stroke. 2007;38(6):2001–23.PubMedCrossRefGoogle Scholar
  75. 75.
    Ko SB, Choi HA, Parikh G, Helbok R, Schmidt JM, Lee K, et al. Multimodality monitoring for cerebral perfusion pressure optimization in comatose patients with intracerebral hemorrhage. Stroke. 2011;42(11):3087–92.PubMedCrossRefGoogle Scholar
  76. 76.
    Halpern NA, Goldberg M, Neely C, Sladen RN, Goldberg JS, Floyd J, et al. Postoperative hypertension: a multicenter, prospective, randomized comparison between intravenous nicardipine and sodium nitroprusside. Crit Care Med. 1992;20(12):1637–43.PubMedCrossRefGoogle Scholar
  77. 77.
    Turner JM, Powell D, Gibson RM, McDowall DG. Intracranial pressure changes in neurosurgical patients during hypotension induced with sodium nitroprusside or trimetaphan. Br J Anaesth. 1977;49(5):419–25.PubMedCrossRefGoogle Scholar
  78. 78.
    Pollack CV, Varon J, Garrison NA, Ebrahimi R, Dunbar L, Peacock WFt. Clevidipine, an intravenous dihydropyridine calcium channel blocker, is safe and effective for the treatment of patients with acute severe hypertension. Ann Emerg Med. 2009;53(3):329–38. doi:10.1016/j.annemergmed.2008.04.025.PubMedCrossRefGoogle Scholar
  79. 79.
    Aronson S, Dyke CM, Stierer KA, Levy JH, Cheung AT, Lumb PD, et al. The ECLIPSE trials: comparative studies of clevidipine to nitroglycerin, sodium nitroprusside, and nicardipine for acute hypertension treatment in cardiac surgery patients. Anesth Analg. 2008;107(4):1110–21. doi:10.1213/ane.0b013e31818240db.PubMedCrossRefGoogle Scholar
  80. 80.
    Levy JH, Mancao MY, Gitter R, Kereiakes DJ, Grigore AM, Aronson S, et al. Clevidipine effectively and rapidly controls blood pressure preoperatively in cardiac surgery patients: the results of the randomized, placebo-controlled efficacy study of clevidipine assessing its preoperative antihypertensive effect in cardiac surgery-1. Anesth Analg. 2007;105(4):918–25. doi:10.1213/01.ane.0000281443.13712.b9. table of contents.PubMedCrossRefGoogle Scholar
  81. 81.
    Singla N, Warltier DC, Gandhi SD, Lumb PD, Sladen RN, Aronson S, et al. Treatment of acute postoperative hypertension in cardiac surgery patients: an efficacy study of clevidipine assessing its postoperative antihypertensive effect in cardiac surgery-2 (ESCAPE-2), a randomized, double-blind, placebo-controlled trial. Anesth Analg. 2008;107(1):59–67. doi:10.1213/ane.0b013e3181732e53.PubMedCrossRefGoogle Scholar
  82. 82.
    Fujii Y, Takeuchi S, Sasaki O, Minakawa T, Tanaka R. Multivariate analysis of predictors of hematoma enlargement in spontaneous intracerebral hemorrhage. Stroke. 1998;29(6):1160–6.PubMedCrossRefGoogle Scholar
  83. 83.
    Fujii Y, Tanaka R, Takeuchi S, Koike T, Minakawa T, Sasaki O. Hematoma enlargement in spontaneous intracerebral hemorrhage. J Neurosurg. 1994;80(1):51–7.PubMedCrossRefGoogle Scholar
  84. 84.
    Kazui S, Naritomi H, Yamamoto H, Sawada T, Yamaguchi T. Enlargement of spontaneous intracerebral hemorrhage. Incidence and time course. Stroke. 1996;27(10):1783–7.PubMedCrossRefGoogle Scholar
  85. 85.
    Mayer SA, Brun NC, Begtrup K, Broderick J, Davis S, Diringer MN, et al. Recombinant activated factor VII for acute intracerebral hemorrhage. N Engl J Med. 2005;352(8):777–85. doi:352/8/777 [pii]10.1056/NEJMoa042991.PubMedCrossRefGoogle Scholar
  86. 86.
    Mayer SA, Brun NC, Begtrup K, Broderick J, Davis S, Diringer MN, et al. Efficacy and safety of recombinant activated factor VII for acute intracerebral hemorrhage. N Engl J Med. 2008;358(20):2127–37. doi:358/20/2127 [pii]10.1056/NEJMoa0707534.PubMedCrossRefGoogle Scholar
  87. 87.
    Mayer SA, Davis SM, Skolnick BE, Brun NC, Begtrup K, Broderick JP, et al. Can a subset of intracerebral hemorrhage patients benefit from hemostatic therapy with recombinant activated factor VII? Stroke. 2009;40(3):833–40. doi:STROKEAHA.108.524470 [pii]10.1161/STROKEAHA.108.524470.PubMedCrossRefGoogle Scholar
  88. 88.
    Flaherty ML. STOP-IT. The Spot Sign for Predicting and Treating ICH Growth Study. http://www.stopitstudy.org/index.html. Accessed 1 February 2012.Google Scholar
  89. 89.
    Wintzen AR, de Jonge H, Loeliger EA, Bots GT. The risk of intracerebral hemorrhage during oral anticoagulant therapy: a population study. Ann Neurol. 1984;16:553–8.PubMedCrossRefGoogle Scholar
  90. 90.
    Hart RG, Boop BS, Anderson DC. Oral anticoagulants and intracranial hemorrhage. Facts and hypotheses. Stroke. 1995;26(8):1471–7.PubMedCrossRefGoogle Scholar
  91. 91.
    Fredriksson K, Norrving B, Stromblad LG. Emergency reversal of anticoagulation after intracerebral hemorrhage. Stroke. 1992;23(7):972–7.PubMedCrossRefGoogle Scholar
  92. 92.
    Makris M, Greaves M, Phillips WS, Kitchen S, Rosendaal FR, Preston EF. Emergency oral anticoagulant reversal: the relative efficacy of infusions of fresh frozen plasma and clotting factor concentrate on correction of the coagulopathy. Thromb Haemost. 1997;77(3):477–80.PubMedGoogle Scholar
  93. 93.
    Yasaka M, Sakata T, Minematsu K, Naritomi H. Correction of INR by prothrombin complex concentrate and vitamin K in patients with warfarin related hemorrhagic complication. Thromb Res. 2002;108(1):25–30.PubMedCrossRefGoogle Scholar
  94. 94.
    Heit JA. Perioperative management of the chronically anticoagulated patient. J Thromb Thrombolysis. 2001;12(1):81–7.PubMedCrossRefGoogle Scholar
  95. 95.
    Sorensen B, Johansen P, Nielsen GL, Sorensen JC, Ingerslev J. Reversal of the International Normalized Ratio with recombinant activated factor VII in central nervous system bleeding during warfarin thromboprophylaxis: clinical and biochemical aspects. Blood Coagul Fibrinolysis: Int J Haemost Thromb. 2003;14(5):469–77.CrossRefGoogle Scholar
  96. 96.
    Erhardtsen E, Nony P, Dechavanne M, Ffrench P, Boissel JP, Hedner U. The effect of recombinant factor VIIa (NovoSeven) in healthy volunteers receiving acenocoumarol to an International Normalized Ratio above 2.0. Blood Coagul Fibrinolysis: Int J Haemost Thromb. 1998;9(8):741–8.CrossRefGoogle Scholar
  97. 97.
    Freeman WD, Brott TG, Barrett KM, Castillo PR, Deen Jr HG, Czervionke LF, et al. Recombinant factor VIIa for rapid reversal of warfarin anticoagulation in acute intracranial hemorrhage. Mayo Clin Proc. 2004;79(12):1495–500.PubMedCrossRefGoogle Scholar
  98. 98.
    Wakefield TW, Stanley JC. Intraoperative heparin anticoagulation and its reversal. Semin Vasc Surg. 1996;9(4):296–302.PubMedGoogle Scholar
  99. 99.
    Mannucci PM, Remuzzi G, Pusineri F, Lombardi R, Valsecchi C, Mecca G, et al. Deamino-8-D-arginine vasopressin shortens the bleeding time in uremia. N Engl J Med. 1983;308(1):8–12.PubMedCrossRefGoogle Scholar
  100. 100.
    Diringer MN, Edwards DF. Admission to a neurologic/neurosurgical intensive care unit is associated with reduced mortality rate after intracerebral hemorrhage. Crit Care Med. 2001;29(3):635–40.PubMedCrossRefGoogle Scholar
  101. 101.
    Mirski MA, Chang CW, Cowan R. Impact of a neuroscience intensive care unit on neurosurgical patient outcomes and cost of care: evidence-based support for an intensivist-directed specialty ICU model of care. J Neurosurg Anesthesiol. 2001;13(2):83–92.PubMedCrossRefGoogle Scholar
  102. 102.
    Hemphill 3rd JC, Newman J, Zhao S, Johnston SC. Hospital usage of early do-not-resuscitate orders and outcome after intracerebral hemorrhage. Stroke. 2004;35(5):1130–4. doi:10.1161/01.STR.0000125858.71051.ca01.STR.0000125858.71051.ca [pii].PubMedCrossRefGoogle Scholar
  103. 103.
    Becker KJ, Baxter AB, Cohen WA, Bybee HM, Tirschwell DL, Newell DW, et al. Withdrawal of support in intracerebral hemorrhage may lead to self-fulfilling prophecies. Neurology. 2001;56(6):766–72.PubMedCrossRefGoogle Scholar
  104. 104.
    Mayer SA, Sacco RL, Shi T, Mohr JP. Neurologic deterioration in noncomatose patients with supratentorial intracerebral hemorrhage. Neurology. 1994;44(8):1379–84.PubMedCrossRefGoogle Scholar
  105. 105.
    Gujjar AR, Deibert E, Manno EM, Duff S, Diringer MN. Mechanical ventilation for ischemic stroke and intracerebral hemorrhage: indications, timing, and outcome. Neurology. 1998;51(2):447–51.PubMedCrossRefGoogle Scholar
  106. 106.
    Rincon F, Mayer SA. Clinical review: Critical care management of spontaneous intracerebral hemorrhage. Crit Care. 2008;12(6):237. doi:cc7092 [pii]10.1186/cc7092.PubMedCrossRefGoogle Scholar
  107. 107.
    Nilsson OG, Lindgren A, Brandt L, Saveland H. Prediction of death in patients with primary intracerebral hemorrhage: a prospective study of a defined population. J Neurosurg. 2002;97(3):531–6.PubMedCrossRefGoogle Scholar
  108. 108.
    Tuhrim S, Horowitz DR, Sacher M, Godbold JH. Volume of ventricular blood is an important determinant of outcome in supratentorial intracerebral hemorrhage. Crit Care Med. 1999;27(3):617–21.PubMedCrossRefGoogle Scholar
  109. 109.
    Bowers SA, Marshall LF. Outcome in 200 consecutive cases of severe head injury treated in San Diego County: a prospective analysis. Neurosurgery. 1980;6:237–42.PubMedCrossRefGoogle Scholar
  110. 110.
    Unwin DH, Giller CA, Kopitnik TA. Central nervous system monitoring: what helps, what does not. Surg Clin North Am. 1991;71:733–47.PubMedGoogle Scholar
  111. 111.
    Qureshi AI, Suri MF, Ringer AJ, Guterman LR, Hopkins LN. Regional intraparenchymal pressure differences in experimental intracerebral hemorrhage: effect of hypertonic saline. Crit Care Med. 2002;30(2):435–41.PubMedCrossRefGoogle Scholar
  112. 112.
    Qureshi AI, Wilson DA, Traystman RJ. Treatment of transtentorial herniation unresponsive to hyperventilation using hypertonic saline in dogs: effect on cerebral blood flow and metabolism. J Neurosurg Anesthesiol. 2002;14(1):22–30.PubMedCrossRefGoogle Scholar
  113. 113.
    Yu YL, Kumana CR, Lauder IJ, Cheung YK, Chan FL, Kou M, et al. Treatment of acute cerebral hemorrhage with intravenous glycerol. A double-blind, placebo-controlled, randomized trial. Stroke. 1992;23(7):967–71.PubMedCrossRefGoogle Scholar
  114. 114.
    Koenig MA, Bryan M, Lewin 3rd JL, Mirski MA, Geocadin RG, Stevens RD. Reversal of transtentorial herniation with hypertonic saline. Neurology. 2008;70(13):1023–9. doi:10.1212/01.wnl.0000304042.05557.60.PubMedCrossRefGoogle Scholar
  115. 115.
    Fernandez-Bouzas A, Harmony T, Fernandez T, Aubert E, Ricardo-Garcell J, Valdes P, et al. Sources of abnormal EEG activity in spontaneous intracerebral hemorrhage. Clin Electroencephalogr. 2002;33(2):70–6.PubMedGoogle Scholar
  116. 116.
    Passero S, Rocchi R, Rossi S, Ulivelli M, Vatti G. Seizures after spontaneous supratentorial intracerebral hemorrhage. Epilepsia. 2002;43(10):1175–80.PubMedCrossRefGoogle Scholar
  117. 117.
    Vespa PM, O'Phelan K, Shah M, Mirabelli J, Starkman S, Kidwell C, et al. Acute seizures after intracerebral hemorrhage: A factor in progressive midline shift and outcome. Neurology. 2003;60(9):1441–6.PubMedCrossRefGoogle Scholar
  118. 118.
    Broderick JP, Adams Jr HP, Barsan W, Feinberg W, Feldmann E, Grotta J, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: A statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 1999;30(4):905–15.PubMedCrossRefGoogle Scholar
  119. 119.
    Greer DM, Funk SE, Reaven NL, Ouzounelli M, Uman GC. Impact of fever on outcome in patients with stroke and neurologic injury. Stroke: A comprehensive meta-analysis; 2008.Google Scholar
  120. 120.
    Aiyagari V, Diringer MN. Fever control and its impact on outcomes: what is the evidence? J Neurol Sci. 2007;261(1–2):39–46.PubMedCrossRefGoogle Scholar
  121. 121.
    Saini M, Saqqur M, Kamruzzaman A, Lees KR, Shuaib A. Effect of hyperthermia on prognosis after acute ischemic stroke. Stroke. 2009;40(9):3051–9. doi:STROKEAHA.109.556134 [pii]10.1161/STROKEAHA.109.556134.PubMedCrossRefGoogle Scholar
  122. 122.
    Szczudlik A, Turaj W, Slowik A, Strojny J. Hyperthermia is not an independent predictor of greater mortality in patients with primary intracerebral hemorrhage. Med Sci Monit: Int Med J Exp Clin Res. 2002;8(10):CR702–7.Google Scholar
  123. 123.
    Baena RC, Busto R, Dietrich WD, Globus MY, Ginsberg MD. Hyperthermia delayed by 24 hours aggravates neuronal damage in rat hippocampus following global ischemia. Neurology. 1997;48(3):768–73.PubMedCrossRefGoogle Scholar
  124. 124.
    Minamisawa H, Smith ML, Siesjo BK. The effect of mild hyperthermia and hypothermia on brain damage following 5, 10, and 15 minutes of forebrain ischemia. Ann Neurol. 1990;28(1):26–33.PubMedCrossRefGoogle Scholar
  125. 125.
    Clasen RA, Pandolfi S, Laing I, Casey Jr D. Experimental study of relation of fever to cerebral edema. J Neurosurg. 1974;41(5):576–81.PubMedCrossRefGoogle Scholar
  126. 126.
    Rossi S, Zanier ER, Mauri I, Columbo A, Stocchetti N. Brain temperature, body core temperature, and intracranial pressure in acute cerebral damage. J Neurol Neurosurg Psychiatry. 2001;71(4):448–54.PubMedCrossRefGoogle Scholar
  127. 127.
    MacLellan CL, Girgis J, Colbourne F. Delayed onset of prolonged hypothermia improves outcome after intracerebral hemorrhage in rats. J Cereb Blood Flow Metab. 2004;24(4):432–40. doi:10.1097/00004647-200404000-00008.PubMedCrossRefGoogle Scholar
  128. 128.
    MacLellan CL, Silasi G, Poon CC, Edmundson CL, Buist R, Peeling J, et al. Intracerebral hemorrhage models in rat: comparing collagenase to blood infusion. J Cereb Blood Flow Metab. 2008;28(3):516–25. doi:10.1038/sj.jcbfm.9600548.PubMedCrossRefGoogle Scholar
  129. 129.
    Kollmar R, Staykov D, Dorfler A, Schellinger PD, Schwab S, Bardutzky J. Hypothermia reduces perihemorrhagic edema after intracerebral hemorrhage. Stroke. 2010;41(8):1684–9. doi:STROKEAHA.110.587758 [pii]10.1161/STROKEAHA.110.587758.PubMedCrossRefGoogle Scholar
  130. 130.
    Schwab S, Georgiadis D, Berrouschot J, Schellinger PD, Graffagnino C, Mayer SA. Feasibility and safety of moderate hypothermia after massive hemispheric infarction. Stroke. 2001;32(9):2033–5.PubMedCrossRefGoogle Scholar
  131. 131.
    Wasserman JK, Zhu X, Schlichter LC. Evolution of the inflammatory response in the brain following intracerebral hemorrhage and effects of delayed minocycline treatment. Brain Res. 2007;1180:140–54. doi:10.1016/j.brainres.2007.08.058.PubMedCrossRefGoogle Scholar
  132. 132.
    Wasserman JK, Schlichter LC. Minocycline protects the blood-brain barrier and reduces edema following intracerebral hemorrhage in the rat. Exp Neurol. 2007;207(2):227–37. doi:10.1016/j.expneurol.2007.06.025.PubMedCrossRefGoogle Scholar
  133. 133.
    Wasserman JK, Schlichter LC. Neuron death and inflammation in a rat model of intracerebral hemorrhage: effects of delayed minocycline treatment. Brain Res. 2007;1136(1):208–18. doi:10.1016/j.brainres.2006.12.035.PubMedCrossRefGoogle Scholar
  134. 134.
    Nakamura T, Keep RF, Hua Y, Schallert T, Hoff JT, Xi G. Deferoxamine-induced attenuation of brain edema and neurological deficits in a rat model of intracerebral hemorrhage. J Neurosurg. 2004;100(4):672–8. doi:10.3171/jns.2004.100.4.0672.PubMedCrossRefGoogle Scholar
  135. 135.
    Gu Y, Hua Y, Keep RF, Morgenstern LB, Xi G. Deferoxamine reduces intracerebral hematoma-induced iron accumulation and neuronal death in piglets. Stroke. 2009;40(6):2241–3. doi:10.1161/STROKEAHA.108.539536.PubMedCrossRefGoogle Scholar
  136. 136.
    Tapia-Perez H, Sanchez-Aguilar M, Torres-Corzo JG, Rodriguez-Leyva I, Gonzalez-Aguirre D, Gordillo-Moscoso A, et al. Use of statins for the treatment of spontaneous intracerebral hemorrhage: results of a pilot study. Central Eur Neurosurg. 2009;70(1):15–20. doi:10.1055/s-0028-1082064.CrossRefGoogle Scholar
  137. 137.
    Lyden PD, Shuaib A, Lees KR, Davalos A, Davis SM, Diener HC, et al. Safety and tolerability of NXY-059 for acute intracerebral hemorrhage: the CHANT Trial. Stroke. 2007;38(8):2262–9. doi:10.1161/STROKEAHA.106.472746.PubMedCrossRefGoogle Scholar
  138. 138.
    Zhao X, Sun G, Zhang J, Strong R, Song W, Gonzales N, et al. Hematoma resolution as a target for intracerebral hemorrhage treatment: role for peroxisome proliferator-activated receptor gamma in microglia/macrophages. Ann Neurol. 2007;61(4):352–62. doi:10.1002/ana.21097.PubMedCrossRefGoogle Scholar
  139. 139.
    Gonzales NR, Shah J, Sangha N, Sosa L, Martinez R, Shen L, et al. Design of a prospective, dose-escalation study evaluating the Safety of Pioglitazone for Hematoma Resolution in Intracerebral Hemorrhage (SHRINC). Int J Stroke. 2012. doi:10.1111/j.1747-4949.2011.00761.x.
  140. 140.
    Selim M. Deferoxamine mesylate: a new hope for intracerebral hemorrhage: from bench to clinical trials. Stroke. 2009;40(3 Suppl):S90–1. doi:10.1161/STROKEAHA.108.533125.PubMedCrossRefGoogle Scholar
  141. 141.
    Kellner CP, Connolly Jr ES. Neuroprotective strategies for intracerebral hemorrhage: trials and translation. Stroke. 2010;41(10 Suppl):S99–102. doi:10.1161/STROKEAHA.110.597476.PubMedCrossRefGoogle Scholar
  142. 142.
    Juvela S, Heiskanen O, Poranen A, Valtonen S, Kuurne T, Kaste M, et al. The treatment of spontaneous intracerebral hemorrhage. A prospective randomized trial of surgical and conservative treatment. J Neurosurg. 1989;70(5):755–8.PubMedCrossRefGoogle Scholar
  143. 143.
    Zuccarello M, Brott T, Derex L, Kothari R, Sauerbeck L, Tew J, et al. Early surgical treatment for supratentorial intracerebral hemorrhage: a randomized feasibility study. Stroke. 1999;30(9):1833–9.PubMedCrossRefGoogle Scholar
  144. 144.
    Fernandes HM, Gregson B, Siddique S, Mendelow AD. Surgery in intracerebral hemorrhage. The uncertainty continues. Stroke. 2000;31(10):2511–6.PubMedCrossRefGoogle Scholar
  145. 145.
    Mendelow AD, Gregson BA, Fernandes HM, Murray GD, Teasdale GM, Hope DT, 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(9457):387–97.PubMedGoogle Scholar
  146. 146.
    Bhattathiri PS, Gregson B, Prasad KS, Mendelow AD. Intraventricular hemorrhage and hydrocephalus after spontaneous intracerebral hemorrhage: results from the STICH trial. Acta Neurochir Suppl. 2006;96:65–8.PubMedCrossRefGoogle Scholar
  147. 147.
    Ott KH, Kase CS, Ojemann RG, Mohr JP. Cerebellar hemorrhage: diagnosis and treatment. A review of 56 cases. Arch Neurol. 1974;31(3):160–7.PubMedCrossRefGoogle Scholar
  148. 148.
    Murthy JM, Chowdary GV, Murthy TV, Bhasha PS, Naryanan TJ. Decompressive craniectomy with clot evacuation in large hemispheric hypertensive intracerebral hemorrhage. Neurocrit Care. 2005;2(3):258–62.PubMedCrossRefGoogle Scholar
  149. 149.
    Auer LM, Deinsberger W, Niederkorn K, Gell G, Kleinert R, Schneider G, et al. Endoscopic surgery versus medical treatment for spontaneous intracerebral hematoma: a randomized study. J Neurosurg. 1989;70(4):530–5.PubMedCrossRefGoogle Scholar
  150. 150.
    Wang WZ, Jiang B, Liu HM, Li D, Lu CZ, Zhao YD, et al. Minimally invasive craniopuncture therapy vs. conservative treatment for spontaneous intracerebral hemorrhage: results from a randomized clinical trial in China. Int J Stroke. 2009;4(1):11–6. doi:IJS239 [pii]10.1111/j.1747-4949.2009.00239.x.PubMedCrossRefGoogle Scholar
  151. 151.
    Teernstra OP, Evers SM, Lodder J, Leffers P, Franke CL, Blaauw G. Stereotactic treatment of intracerebral hematoma by means of a plasminogen activator: a multicenter randomized controlled trial (SICHPA). Stroke. 2003;34(4):968–74.PubMedCrossRefGoogle Scholar
  152. 152.
    Naff NJ, Carhuapoma JR, Williams MA, Bhardwaj A, Ulatowski JA, Bederson J, et al. Treatment of intraventricular hemorrhage with urokinase: effects on 30-Day survival. Stroke. 2000;31(4):841–7.PubMedCrossRefGoogle Scholar
  153. 153.
    Coplin WM, Vinas FC, Agris JM, Buciuc R, Michael DB, Diaz FG, et al. A cohort study of the safety and feasibility of intraventricular urokinase for nonaneurysmal spontaneous intraventricular hemorrhage. Stroke. 1998;29(8):1573–9.PubMedCrossRefGoogle Scholar
  154. 154.
    Lapointe M, Haines S. Fibrinolytic therapy for intraventricular hemorrhage in adults. Cochrane Database Syst Rev. 2002;3:CD003692.PubMedGoogle Scholar
  155. 155.
    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.PubMedCrossRefGoogle Scholar
  156. 156.
    Measuring and improving quality of care: a report from the American Heart Association/American College of Cardiology First Scientific Forum on Assessment of Healthcare Quality in Cardiovascular Disease and Stroke. Circulation. 2000;101(12):1483-93.Google Scholar
  157. 157.
    Mayer SA, Rincon F. Treatment of intracerebral haemorrhage. Lancet Neurol. 2005;4(10):662–72.PubMedCrossRefGoogle Scholar
  158. 158.
    Lozier AP, Sciacca RR, Romagnoli MF, Connolly Jr ES. Ventriculostomy-related infections: a critical review of the literature. Neurosurgery. 2002;51(1):170–81. discussion 81-2.PubMedCrossRefGoogle Scholar
  159. 159.
    Lundberg N. Continuous recording and control of ventricular fluid pressure in neurosurgical practice. Acta Psychiatr Scand Suppl. 1960;36(149):1–193.PubMedGoogle Scholar
  160. 160.
    Chambers IR, Banister K, Mendelow AD. Intracranial pressure within a developing intracerebral haemorrhage. Br J Neurosurg. 2001;15(2):140–1.PubMedCrossRefGoogle Scholar
  161. 161.
    Fernandes HM, Siddique S, Banister K, Chambers I, Wooldridge T, Gregson B, et al. Continuous monitoring of ICP and CPP following ICH and its relationship to clinical, radiological and surgical parameters. Acta Neurochir Suppl. 2000;76:463–6.PubMedGoogle Scholar
  162. 162.
    Qureshi AI, Suarez JI. Use of hypertonic saline solutions in treatment of cerebral edema and intracranial hypertension. Crit Care Med. 2000;28(9):3301–13.PubMedCrossRefGoogle Scholar
  163. 163.
    Qureshi AI, Geocadin RG, Suarez JI, Ulatowski JA. Long-term outcome after medical reversal of transtentorial herniation in patients with supratentorial mass lesions. Crit Care Med. 2000;28(5):1556–64.PubMedCrossRefGoogle Scholar
  164. 164.
    Shiozaki T, Sugimoto H, Taneda M, Yoshida H, Iwai A, Yoshioka T, et al. Effect of mild hypothermia on uncontrollable intracranial hypertension after severe head injury. J Neurosurg. 1993;79(3):363–8.PubMedCrossRefGoogle Scholar
  165. 165.
    Schwab S, Spranger M, Schwarz S, Hacke W. Barbiturate coma in severe hemispheric stroke: useful or obsolete? Neurology. 1997;48(6):1608–13.PubMedCrossRefGoogle Scholar
  166. 166.
    Rincon F, Mayer SA. Therapeutic hypothermia for brain injury after cardiac arrest. Semin Neurol. 2006;26(4):387–95.PubMedCrossRefGoogle Scholar
  167. 167.
    Mayer SA, Rincon FR, Mohr JP. Intracerebral Hemorrhage. In: Rowland D, Pedley TA, editors. Merritt's Neurology. Philadelphia: Lippincott Williams & Wilkins; 2009. p. 276–80.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Neurology and Neurosurgery, Division of Critical Care and NeurotraumaThomas Jefferson UniversityPhiladelphiaUSA
  2. 2.Department of Neurology and Neurosurgery, Division of Stroke and Critical Care, College of Physicians and SurgeonsColumbia UniversityNew YorkUSA
  3. 3.Neurological Intensive Care UnitMilstein Hospital BuildingNew YorkUSA

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