Intracerebral hemorrhage: update and future directions

ABSTRACT

Intracerebral hemorrhage (ICH), defined as bleeding into the brain parenchyma, is a significant public health issue. Although it accounts for only 10 to 15% of strokes, it is associated with the highest morbidity and mortality rates. Despite advances in the field of stroke and neurocritical care, the principles of acute management have fundamentally remained the same over many years. The main treatment strategies include aggressive blood pressure control, early hemostasis, reversal of coagulopathies, clot evacuation through open surgical or minimally invasive surgical techniques, and the management of raised intracranial pressure.

RESUMO

A hemorragia cerebral é definida como um sangramento no parênquima cerebral e representa um importante problema de saúde pública. Ela corresponde a 10 a 15% das causas de AVC e está associada a altas taxas de morbimortalidade. Apesar dos avanços no campo do AVC e dos cuidados neurocríticos, os princípios do manejo agudo permaneceram fundamentalmente os mesmos por muitos anos. As principais estratégias de tratamento incluem controle agressivo da pressão arterial, hemostasia precoce, reversão de coagulopatias, evacuação do coágulo por meio de técnicas cirúrgicas abertas ou cirúrgicas minimamente invasivas e gerenciamento da pressão intracraniana elevada.

Keywords:

Cerebral Hemorrhage - Stroke - Critical Care

Palavras-chave:

Hemorragia Cerebral - Acidente Vascular Cerebral - Cuidados Críticos

Authors’ contributions:

Dr. Eva Rocha conceptualized and drafted the manuscript; Dr. Carolina Rouanet drafted the manuscript; Dr. Danyelle Reges drafted the manuscript; Dr. Vivian Gagliardi drafted the manuscript; Dr. Aneesh Bhim Singhal revised the manuscript for intelectual content; Dr. Gisele Sampaio Silva conceptualized and revised the manuscript for intellectual content.

Support:

Dr. Eva Rocha’s visiting scholarship at Massachusetts General Hospital and Harvard Medical School, Boston, was sponsored by the Capes Foundation, Ministry of Education, Brazil (grant No. 88881.133101/2016-01).

Publication History

Received: 16 February 2020

Accepted: 08 April 2020

Article published online:
13 June 2023

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