Management of hemorrhagic stroke.

Fifty thousand Americans suffer an intracerebral hemorrhage (ICH) annually, one third of whom die as a result. Poorly controlled hypertension is the most important risk factor for ICH. Over time it results in pathologic changes to small intracranial vessels, leading to their rupture. All stroke patients, including those with suspected ICH, require emergent evaluation. Surgical intervention is appropriate for some ICH patients, although intensive medical management of intracranial pressure and the systemic consequences of ICH can reduce morbidity in all. Innovative medical and surgical therapeutic approaches hold promise for improved treatment in the future, but prevention is the key for reducing morbidity in the short term.