Open AccessA contemporary review of therapeutic and regenerative management of intracerebral hemorrhage
Author(s) -
Sadaf Humaira,
Desai Virendra R.,
Misra Vivek,
Golanov Eugene,
Hegde Muralidhar L.,
Villapol Sonia,
Karmonik Christof,
RegnierGolanov Angelique,
Sayenko Dimitri,
Horner Philip J.,
Krencik Robert,
Weng Yi Lan,
Vahidy Farhaan S.,
Britz Gavin W.
Publication year - 2021
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.51443
Subject(s) - medicine , intracerebral hemorrhage , coagulopathy , intensive care medicine , hematoma , intracranial pressure , stroke (engine) , neurointensive care , intraventricular hemorrhage , intracerebral hematoma , surgery , subarachnoid hemorrhage , gestational age , mechanical engineering , pregnancy , biology , engineering , genetics
Intracerebral hemorrhage (ICH) remains a common and debilitating form of stroke. This neurological emergency must be diagnosed and treated rapidly yet effectively. In this article, we review the medical, surgical, repair, and regenerative treatment options for managing ICH. Topics of focus include the management of blood pressure, intracranial pressure, coagulopathy, and intraventricular hemorrhage, as well as the role of surgery, regeneration, rehabilitation, and secondary prevention. Results of various phase II and III trials are incorporated. In summary, ICH patients should undergo rapid evaluation with neuroimaging, and early interventions should include systolic blood pressure control in the range of 140 mmHg, correction of coagulopathy if indicated, and assessment for surgical intervention. ICH patients should be managed in dedicated neurosurgical intensive care or stroke units where continuous monitoring of neurological status and evaluation for neurological deterioration is rapidly possible. Extravasation of hematoma may be helpful in patients with intraventricular extension of ICH. The goal of care is to reduce mortality and enable multimodal rehabilitative therapy.