Foreword

Intracerebral Hemorrhage is the first major text devoted to non-traumatic intracerebral hemorrhage (ICH) to appear in almost 20 years. The 21 chapters detail a generation of progress since the introduction of brain computerized tomography (CT) in 1973. At that time, and for the first time, the phenotype of non-traumatic ICH could be clarified. The Polaroid-print images of ICH pasted into patient medical records were understandable in all languages. The distinction between ICH and territorial cerebral infarction was no longer fuzzy, to await the final verdict at the autopsy table. Testable hypotheses replaced speculation. During the next two decades, faster and more accurate CT scanning and then magnetic resonance imaging (MRI) allowed rigorous clinical-radiographic studies (Chapters 8-10). Publications related to ICH sky-rocketed in number. In 1991, the National Institutes of Health funded the first investigator-initiated R01 research grant to study ICH in emergency departments. The US federal funding of additional studies of ICH surged. Worldwide, CT-based clinical studies described the dynamic profile of ICH. The pivotal role of ICH volume growth in clinical deterioration during the first minutes and hours after symptom onset was established. In parallel with the studies of ICH in the emergency department setting, experimental (Chapters 17, 18) and clinical studies proceeded (Chapters 1-8). Subtypes of ICH were identified with greater precision, facilitating epidemiological studies, mechanistic experimental studies, and, more recently, genetic studies by subtype.