Edward M Manno1. 1. Neurological Intensive Care Unit, Cleveland Clinic, 9500 Euclid Ave, Desk S 80, Cleveland, OH 44195, USA. mannoe@ccf.org
Abstract
PURPOSE OF REVIEW: This article provides an update on the latest diagnostic and therapeutic trials relating to the management of intracerebral hemorrhage (ICH). RECENT FINDINGS: Early hematoma expansion and worsening cerebral edema may account for delayed neurologic deterioration after ICH. SUMMARY: Despite advances in other areas of stroke, there has been no significant improvement in the morbidity and mortality after ICH. The cause of ICH has been shifting from chronic hypertension to other etiologies. Current understanding of the pathophysiologic processes involved with hematoma expansion and the development of secondary injury after ICH has focused the treatment strategies on prevention of these potential complications. Care for the patient after ICH includes basic medical care, prevention of hematoma expansion, and treatment of potential secondary complications. Trials are underway to evaluate the effect of acute blood pressure control on hematoma expansion and the development of cerebral edema. Similarly, new surgical techniques are being explored for clot removal, and medical therapies are being developed to prevent secondary neurotoxic damage.
PURPOSE OF REVIEW: This article provides an update on the latest diagnostic and therapeutic trials relating to the management of intracerebral hemorrhage (ICH). RECENT FINDINGS: Early hematoma expansion and worsening cerebral edema may account for delayed neurologic deterioration after ICH. SUMMARY: Despite advances in other areas of stroke, there has been no significant improvement in the morbidity and mortality after ICH. The cause of ICH has been shifting from chronic hypertension to other etiologies. Current understanding of the pathophysiologic processes involved with hematoma expansion and the development of secondary injury after ICH has focused the treatment strategies on prevention of these potential complications. Care for the patient after ICH includes basic medical care, prevention of hematoma expansion, and treatment of potential secondary complications. Trials are underway to evaluate the effect of acute blood pressure control on hematoma expansion and the development of cerebral edema. Similarly, new surgical techniques are being explored for clot removal, and medical therapies are being developed to prevent secondary neurotoxic damage.
Authors: Roslyn A Taylor; Che-Feng Chang; Brittany A Goods; Matthew D Hammond; Brian Mac Grory; Youxi Ai; Arthur F Steinschneider; Stephen C Renfroe; Michael H Askenase; Louise D McCullough; Scott E Kasner; Michael T Mullen; David A Hafler; J Christopher Love; Lauren H Sansing Journal: J Clin Invest Date: 2016-11-28 Impact factor: 19.456
Authors: Lina Marenco-Hillembrand; Paola Suarez-Meade; Henry Ruiz Garcia; Ricardo Murguia-Fuentes; Erik H Middlebrooks; Lindsey Kangas; W David Freeman; Kaisorn L Chaichana Journal: Stroke Vasc Neurol Date: 2019-09-26