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Translational Stroke Research
Published in: Translational Stroke Research 1/2012

01-07-2012 | Review Article

Intracerebral Hemorrhage: Clinical Overview and Pathophysiologic Concepts

Authors: Fred Rincon, Stephan A. Mayer

Published in: Translational Stroke Research | Special Issue 1/2012

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Abstract

Intracerebral hemorrhage is by far the most destructive form of stroke. Apart from the management in a specialized stroke or neurological intensive care unit (NICU), no specific therapies have been shown to consistently improve outcomes after ICH. Current guidelines endorse early aggressive optimization of physiologic derangements with ventilatory support when indicated, blood pressure control, reversal of any preexisting coagulopathy, intracranial pressure monitoring for certain cases, osmotherapy, temperature modulation, seizure prophylaxis, treatment of hyerglycemia, and nutritional support in the stroke unit or NICU. Ventriculostomy is the cornerstone of therapy for control of intracranial pressure patients with intraventricular hemorrhage. Surgical hematoma evacuation does not improve outcome for more patients, but is a reasonable option for patients with early worsening due to mass effect due to large cerebellar or lobar hemorrhages. Promising experimental treatments currently include ultra-early hemostatic therapy, intraventricular clot lysis with thrombolytics, pioglitazone, temperature modulation, and deferoxamine to reduce iron-mediated perihematomal inflammation and tissue injury.
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Metadata
Title
Intracerebral Hemorrhage: Clinical Overview and Pathophysiologic Concepts
Authors
Fred Rincon
Stephan A. Mayer
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
Translational Stroke Research / Issue Special Issue 1/2012
Print ISSN: 1868-4483
Electronic ISSN: 1868-601X
DOI
https://doi.org/10.1007/s12975-012-0175-8

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