Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
, 30 (5), 555-64

Spontaneous Intracerebral Hemorrhage

Affiliations
Review

Spontaneous Intracerebral Hemorrhage

Maria I Aguilar et al. Semin Neurol.

Abstract

Spontaneous intracerebral hemorrhage (sICH) is defined as bleeding within the brain parenchyma, and occurs twice as commonly as subarachnoid hemorrhage, but is equally as deadly. Risk factors for sICH include hypertension, advanced age, leukoaraiosis, prior ICH, renal failure, use of anticoagulant drugs, and cerebral amyloid angiopathy. When a patient is clinically suspected of having sICH, head computed tomography scan is the standard diagnostic tool. However, newer magnetic resonance neuroimaging techniques may aid in determining the underlying pathology and aid in prognosis. Supportive care and blood pressure management are important in the care of patients with sICH. Ongoing research is aimed at determining a safe blood pressure goal that may also prevent expansion of hemorrhage. Hemostatic medications and neuroprotectants have thus far not shown clinical improvement. Although several neurosurgical trials have failed to demonstrate benefit for surgical evacuation of sICH, multiple research trials are ongoing investigating acute blood pressure control, deep or basal ganglionic hemorrhage evacuation via minimally invasive approach (MISTIE; http://mistietrial.com/default.aspx), lobar ICH evacuation (STICH; II http://research.ncl.ac.uk/stich/), and intraventricular thrombolysis with tissue plasminogen activator (tPA) (CLEAR III; http://biosgroup-johnshopkinsmedicine.health.officelive.com/default.aspx).

Similar articles

  • Spontaneous Intracerebral Hemorrhage: A Review
    ME Fewel et al. Neurosurg Focus 15 (4), E1. PMID 15344894. - Review
    Spontaneous intracerebral hemorrhage (SICH) is a blood clot that arises in the brain parenchyma in the absence of trauma or surgery. This entity accounts for 10 to 15% of …
  • Intracerebral Hemorrhage
    L Elijovich et al. Semin Neurol 28 (5), 657-67. PMID 19115172. - Review
    Intracerebral hemorrhage (ICH) accounts for 10 to 15% of all strokes, but results in a disproportionately high morbidity and mortality. Although chronic hypertension acco …
  • Update in Intracerebral Hemorrhage
    MI Aguilar et al. Neurohospitalist 1 (3), 148-59. PMID 23983850.
    Spontaneous, nontraumatic intracerebral hemorrhage (ICH) is defined as bleeding within the brain parenchyma. Intracranial hemorrhage includes bleeding within the cranial …
  • [Management and Predictors in Patients With Spontaneous Intracerebral Hemorrhage]
    A Tellería-Díaz. Rev Neurol 42 (6), 341-9. PMID 16575770. - Review
    The 30-day mortality of SICH remains dismal (42%) despite modern ICUs. Recent prognostic studies have brought new insights about various SICH predictors, but even so ther …
  • Anticoagulant-associated Intracerebral Hemorrhage
    ML Flaherty. Semin Neurol 30 (5), 565-72. PMID 21207349. - Review
    The incidence of anticoagulant-associated intracerebral hemorrhage (AAICH) quintupled during the 1990 s, probably due to increased warfarin use for the treatment of atria …
See all similar articles

Cited by 19 PubMed Central articles

See all "Cited by" articles

MeSH terms

Feedback