Ischemic Events After Intracerebral Hemorrhage: A New Target for Secondary Prevention

Spontaneous intracerebral hemorrhage (ICH) has a case fatality at 1 month of approximately 40%. Survivors of ICH face a risk of recurrent ICH of approximately 1% to 7% per year,2"4 depending on clinical factors (eg, age, hypertension, or anticoagulation), neuroimaging results (eg, lobar location of the ICH, arteriovenous malformation, or associated cerebral microbleeding), and capacity to treat the underlying cause of the ICH.5 Because 85% of cases of spontaneous ICH are caused by cerebral small vessel disease (predominantly hypertensive deep perforator arteriopathy and cerebral amyloid angiopathy), guidelines for the management of ICH emphasize risk assessment, lifestyle management, and maintaining blood pressure below 130/80 mm Hg to prevent recurrent ICH.