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Practice Guideline
. 2010 Sep;41(9):2108-29.
doi: 10.1161/STR.0b013e3181ec611b. Epub 2010 Jul 22.

Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association

Lewis B Morgenstern, J Claude Hemphill 3rd, Craig Anderson, Kyra Becker, Joseph P Broderick, E Sander Connolly Jr, Steven M Greenberg, James N Huang, R Loch MacDonald, Steven R Messé, Pamela H Mitchell, Magdy Selim, Rafael J Tamargo; American Heart Association Stroke Council and Council on Cardiovascular Nursing
Practice Guideline

Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association

Lewis B Morgenstern et al. Stroke. 2010 Sep.

Abstract

Purpose: The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of acute spontaneous intracerebral hemorrhage.

Methods: A formal literature search of MEDLINE was performed. Data were synthesized with the use of evidence tables. Writing committee members met by teleconference to discuss data-derived recommendations. The American Heart Association Stroke Council's Levels of Evidence grading algorithm was used to grade each recommendation. Prerelease review of the draft guideline was performed by 6 expert peer reviewers and by the members of the Stroke Council Scientific Statements Oversight Committee and Stroke Council Leadership Committee. It is intended that this guideline be fully updated in 3 years' time.

Results: Evidence-based guidelines are presented for the care of patients presenting with intracerebral hemorrhage. The focus was subdivided into diagnosis, hemostasis, blood pressure management, inpatient and nursing management, preventing medical comorbidities, surgical treatment, outcome prediction, rehabilitation, prevention of recurrence, and future considerations.

Conclusions: Intracerebral hemorrhage is a serious medical condition for which outcome can be impacted by early, aggressive care. The guidelines offer a framework for goal-directed treatment of the patient with intracerebral hemorrhage.

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Conflict of interest statement

The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.

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Figure 1
Figure 1
Intracranial Pressure Treatment Algorithm (adapted from Brain Trauma Foundation Head Injury Guidelines)
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