Advances in Therapeutic Approaches for Spontaneous Intracerebral Hemorrhage

Spontaneous intracerebral hemorrhage (ICH) results in high rates of morbidity and mortality, with intraventricular hemorrhage (IVH) being associated with even worse outcomes. Therapeutic interventions in acute ICH have continued to emerge with focus on arresting hemorrhage expansion, clot volume red...

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Veröffentlicht in:Neurotherapeutics 2020-10, Vol.17 (4), p.1757-1767
Hauptverfasser: Al-Kawaz, Mais N., Hanley, Daniel F., Ziai, Wendy
Format: Artikel
Sprache:eng
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Zusammenfassung:Spontaneous intracerebral hemorrhage (ICH) results in high rates of morbidity and mortality, with intraventricular hemorrhage (IVH) being associated with even worse outcomes. Therapeutic interventions in acute ICH have continued to emerge with focus on arresting hemorrhage expansion, clot volume reduction of both intraventricular and parenchymal hematomas, and targeting perihematomal edema and inflammation. Large randomized controlled trials addressing the effectiveness of rapid blood pressure lowering, hemostatic therapy with platelet transfusion, and other clotting complexes and hematoma volume reduction using minimally invasive techniques have impacted clinical guidelines. We review the recent evolution in the management of acute spontaneous ICH, discussing which interventions have been shown to be safe and which may potentially improve outcomes.
ISSN:1933-7213
1878-7479
1878-7479
DOI:10.1007/s13311-020-00902-w