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01-08-2006 | REVIEW

Update on intracerebral haemorrhage

Author: José M. Ferro

Published in: Journal of Neurology | Issue 8/2006

Abstract

Intracerebral haemorrhage (ICH) is a common and serious disease. About 1 to 2 out of 10 patients with stroke have an ICH. The mortality of ICH is higher than that of ischaemic stroke. Only 31% are functionally independent at 3 months. Only 38% of the patients survive the 1^st year. The cost of ICH is high.

Hypertension is the major risk factor, increasing the risk of ICH about 4x. Up to half of hypertensive patients who suffer a ICH are either unaware of their hypertension, non-compliant with the medication or fail to control periodically their blood pressure levels Microbleeds and white matter changes are MRI markers of the risk of ICH. ICH has 3 main pathophysiological phases: arterial rupture and haematoma formation, haematoma enlargement and peri-haematoma oedema. Up to 40% of the haematomas grow in the first hours post-rupture. ICH growth is associated with early clinical deterioration. Two randomised clinical trials (RCTs) demonstrated that treatment with rFVIIa limited haematoma growth and improved outcome, but was associated with a increase in thromboembolic complications. Ventricular drainage with thrombolytics might improve outcome for patients with intraventricular bleeding. A large RCT and meta-analysis failed to show a benefit of surgery over conservative treatment in acute ICH.

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Title: Update on intracerebral haemorrhage
Author: José M. Ferro
Publication date: 01-08-2006
Publisher: Steinkopff-Verlag
Published in: Journal of Neurology / Issue 8/2006
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-006-0201-4

At a glance: The STEP trials

Springer Medicine

Update on intracerebral haemorrhage

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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