Advances in the care of patients with intracerebral hemorrhage

Kristine M. Thompson, Sharon Y. Gerlach, H. Keels S. Jorn, Jan M. Larson, Thomas G. Brott, Julia A. Files

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations


Intracerebral hemorrhage (ICH), which comprises 15% to 30% of all strokes, has an estimated incidence of 37,000 cases per year. One third of patients are actively bleeding when they present to the emergency department, and hematoma growth during the first hours after ICH onset is thought to be a prime determinant of clinical deterioration. Inflammation, as opposed to ischemia, also negatively affects patient condition. Recombinant activated factor VII is emerging as a potential first-line therapy, especially in warfarin-associated hemorrhage. Corticosteroid therapy is not supported by contemporary studies or by current management guidelines. Aggressive blood pressure reduction is under investigation. Surgical intervention has shown no statistically significant benefit over medical management for patients with ICH in general, although subgroup analysis in a large randomized trial suggested potential benefits from surgery for patients with lobar ICH. Not long ago, ICH was considered virtually untreatable. Diligent efforts in both bench and clinical research are generating hope for patients who experience this catastrophic event.

Original languageEnglish (US)
Pages (from-to)987-990
Number of pages4
JournalMayo Clinic proceedings
Issue number8
StatePublished - Aug 2007

ASJC Scopus subject areas

  • General Medicine


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