Management of intracerebral hemorrhage

A. M. Thabet, M. Kottapally, J. Claude Hemphill

Research output: Chapter in Book/Report/Conference proceedingChapter

30 Scopus citations

Abstract

Intracerebral hemorrhage (ICH) is a potentially devastating neurologic injury representing 10–15% of stroke cases in the USA each year. Numerous risk factors, including age, hypertension, male gender, coagulopathy, genetic susceptibility, and ethnic descent, have been identified. Timely identification, workup, and management of this condition remain a challenge for clinicians as numerous factors can present obstacles to achieving good functional outcomes. Several large clinical trials have been conducted over the prior decade regarding medical and surgical interventions. However, no specific treatment has shown a major impact on clinical outcome. Current management guidelines do exist based on medical evidence and consensus and these provide a framework for care. While management of hypertension and coagulopathy are generally considered basic tenets of ICH management, a variety of measures for surgical hematoma evacuation, intracranial pressure control, and intraventricular hemorrhage can be further pursued in the emergent setting for selected patients. The complexity of management in parenchymal cerebral hemorrhage remains challenging and offers many areas for further investigation. A systematic approach to the background, pathology, and early management of spontaneous parenchymal hemorrhage is provided.

Original languageEnglish (US)
Title of host publicationHandbook of Clinical Neurology
PublisherElsevier B.V.
Pages177-194
Number of pages18
DOIs
StatePublished - 2017

Publication series

NameHandbook of Clinical Neurology
Volume140
ISSN (Print)0072-9752
ISSN (Electronic)2212-4152

Keywords

  • coagulopathy
  • hypertension
  • imaging
  • intracerebral hemorrhage
  • management
  • surgery

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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