Critical care management of intracerebral hemorrhage

Crit Care Clin. 2014 Oct;30(4):699-717. doi: 10.1016/j.ccc.2014.06.003. Epub 2014 Jul 30.


Primary, spontaneous intracerebral hemorrhage (ICH) confers significant early mortality and long-term morbidity worldwide. Advances in acute care including investigative, diagnostic, and management strategies are important to improving outcomes for patients with ICH. Physicians caring for patients with ICH should anticipate the need for emergent blood pressure reduction, coagulopathy reversal, cerebral edema management, and surgical interventions including ventriculostomy and hematoma evacuation. This article reviews the pathogenesis and diagnosis of ICH, and details the acute management of spontaneous ICH in the critical care setting according to existing evidence and published guidelines.

Keywords: Anticoagulants/adverse effects; Antihypertensive agents/therapeutic use; Blood coagulation disorders; Hypertensive/diagnosis/cause/therapy; Intracerebral hemorrhage; Neurocritical care; Neurosurgical procedures.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants / therapeutic use*
  • Antihypertensive Agents / therapeutic use*
  • Blood Coagulation Disorders / complications
  • Blood Coagulation Disorders / drug therapy*
  • Brain Edema / drug therapy*
  • Brain Edema / etiology
  • Cerebral Hemorrhage / complications
  • Cerebral Hemorrhage / diagnosis*
  • Cerebral Hemorrhage / therapy*
  • Child
  • Child, Preschool
  • Critical Care / methods*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Young Adult


  • Anticoagulants
  • Antihypertensive Agents