Intracerebral hemorrhage

Lucas Elijovich, Pratik V. Patel, J. Claude Hemphill

Research output: Contribution to journalReview article

48 Citations (Scopus)

Abstract

Intracerebral hemorrhage (ICH) accounts for 10 to 15% of all strokes, but results in a disproportionately high morbidity and mortality. Although chronic hypertension accounts for the majority of ICH, other common causes include cerebral amyloid angiopathy, sympathomimetic drugs of abuse, and underlying cerebral vascular anomalies. Validated baseline predictors of clinical outcome after ICH include the Glasgow Coma Scale score, hematoma volume, presence and amount of intraventricular hemorrhage, infratentorial ICH location, and advanced age. Although no treatment of proven benefit currently exists for ICH, several recent large clinical trials have demonstrated the feasibility of surgical and medical treatments for ICH. Clinical research into ICH mechanisms of injury has demonstrated that hematoma expansion is common, even in patients without coagulopathy. Basic research has suggested that perihematoma injury is more likely related to toxicity of blood and iron in the brain (" neurohemoinflammation") rather than primary ischemic injury. Current guidelines for ICH treatment emphasize blood pressure management, urgent and rapid correction of coagulopathy, and surgery for cerebellar ICH. Ongoing clinical trials are investigating surgical evacuation of lobar hemorrhage, minimally invasive surgical hematoma evacuation, and aggressive blood pressure lowering.

Original languageEnglish (US)
Pages (from-to)657-667
Number of pages11
JournalSeminars in Neurology
Volume28
Issue number5
DOIs
StatePublished - Nov 1 2008
Externally publishedYes

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Cerebral Hemorrhage
Hematoma
Wounds and Injuries
Clinical Trials
Cerebral Amyloid Angiopathy
Hemorrhage
Blood Pressure
Sympathomimetics
Glasgow Coma Scale
Street Drugs
Research
Blood Vessels
Therapeutics
Iron
Stroke
Guidelines
Hypertension
Morbidity
Mortality
Brain

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Neurology

Cite this

Intracerebral hemorrhage. / Elijovich, Lucas; Patel, Pratik V.; Hemphill, J. Claude.

In: Seminars in Neurology, Vol. 28, No. 5, 01.11.2008, p. 657-667.

Research output: Contribution to journalReview article

Elijovich, L, Patel, PV & Hemphill, JC 2008, 'Intracerebral hemorrhage', Seminars in Neurology, vol. 28, no. 5, pp. 657-667. https://doi.org/10.1055/s-0028-1105974
Elijovich, Lucas ; Patel, Pratik V. ; Hemphill, J. Claude. / Intracerebral hemorrhage. In: Seminars in Neurology. 2008 ; Vol. 28, No. 5. pp. 657-667.
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