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Chapter 12 - Intracerebral Hemorrhage

Published online by Cambridge University Press:  28 October 2019

Mary Carter Denny
Affiliation:
Georgetown University Hospital
Ahmad Riad Ramadan
Affiliation:
Henry Ford Hospital, Detroit
Sean I. Savitz
Affiliation:
University of Texas Health Science Center, Houston
James Grotta
Affiliation:
Memorial Hermann Texas Medical School
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Summary

In this chapter, we consider spontaneous hemorrhage into the brain parenchyma and ventricles (intracerebral hemorrhage, ICH). Non-traumatic bleeding into the subarachnoid space (subarachnoid hemorrhage, SAH) is covered in Chapter 13. Traumatic subdural and epidural hemorrhages are not covered in this book.

Intracerebral hemorrhage is associated with very high morbidity and mortality. It is important to realize that, as with acute ischemic strokes, time is of the essence in ICH. The reason for this is that the blood accumulates rapidly, and the volume of the hematoma is the most important determinant of outcome.

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Chapter
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Acute Stroke Care , pp. 175 - 197
Publisher: Cambridge University Press
Print publication year: 2019

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References

LoPresti, MA, Bruce, SS, Camacho, E, et al. Hematoma volume as the major determinant of outcomes after intracerebral hemorrhage. J Neurol Sci 2014; 345: 37.CrossRefGoogle ScholarPubMed
Qureshi, AI, Tuhrim, S, Broderick, JP, et al. Spontaneous intracerebral hemorrhage. N Engl J Med 2001; 344: 14501460.CrossRefGoogle ScholarPubMed
Beslow, LA, Ichord, RN, Kasner, SE, et al. ABC/XYZ estimates intracerebral hemorrhage volume as a percent of total brain volume in children. Stroke 2010; 41: 691694.Google Scholar
Brott, T, Broderick, J, Kothari, R, et al. Early hemorrhage growth in patients with intracerebral hemorrhage. Stroke 1997; 28: 15.Google Scholar
Al-Mufti, F, Thabet, AM, Singh, T, et al. Clinical and radiographic predictors of intracerebral hemorrhage outcome. Interv Neurol 2018; 7: 118136.Google Scholar
Morotti, A, Brouwers, HB, Romero, JM, et al.; Antihypertensive Treatment of Acute Cerebral Hemorrhage II and Neurological Emergencies Treatment Trials Investigators. Intensive blood pressure reduction and spot sign in intracerebral hemorrhage: a secondary analysis of a randomized clinical trial. JAMA Neurol 2017; 74: 950960. doi:10.1001/jamaneurol.2017.1014.Google Scholar
Hemphill, JC, Greenberg, SM, Anderson, CS, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2015; 46: 20322060.Google Scholar
Mayer, SA, Brun, NC, Begtrup, K, et al.; FAST Trial Investigators. Efficacy and safety of recombinant activated factor VII for acute intracerebral hemorrhage. N Engl J Med 2008; 358: 21272137.CrossRefGoogle ScholarPubMed
Steiner, T, Poli, S, Griebe, M, et al. Fresh frozen plasma versus prothrombin complex concentrate in patients with intracranial haemorrhage related to vitamin K antagonists (INCH): a randomised trial. Lancet Neurol 2016; 15: 566573.CrossRefGoogle Scholar
Baharoglu, MI, Cordonnier, C, Al-Shahi Salman, R, et al.; PATCH Investigators. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet 2016; 387: 26052613.CrossRefGoogle Scholar
Butcher, KS, Jeerakathil, T, Hill, M, et al.; ICH ADAPT Investigators. The Intracerebral Hemorrhage Acutely Decreasing Arterial Pressure trial. Stroke 2013; 44: 620626.Google Scholar
Anderson, CS, Heeley, E, Huang, Y, et al.; INTERACT2 Investigators. Rapid blood-pressure lowering in patients with acute intracerebral hemorrhage. N Engl J Med 2013; 368: 23552365.Google Scholar
Qureshi, AI, Palesch, YY, Barsan, WG, et al.; ATACH-2 Trial Investigators, Neurological Emergency Treatment Trials Network. Intensive blood-pressure lowering in patients with acute cerebral hemorrhage. N Engl J Med 2016; 375: 10331043.CrossRefGoogle ScholarPubMed
Mendelow, AD, Gregson, BA, Fernandes, HM, et al.; STICH Investigators. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trial. Lancet 2005; 365: 387397.CrossRefGoogle Scholar
Mendelow, AD, Gregson, BA, Rowan, EN, et al.; STICH II Investigators. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial. Lancet 2013; 382: 397408.Google Scholar
Hanley, DF, Thompson, RE, Rosenblum, M, et al.; MISTIE III Investigators. Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trial. Lancet 2019; 393: 10211032. doi: 10.1016/S0140-6736(19)30195-3.Google Scholar
ENRICH: Early MiNimally-invasive Removal of IntraCerebral Hemorrhage (ICH) (ENRICH). ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT02880878 (accessed June 2019).Google Scholar
Hanley DF, Lane K, McBee N, et al.; CLEAR III Investigators. Thrombolytic removal of intraventricular haemorrhage in treatment of severe stroke: results of the randomised, multicentre, multiregion, placebo-controlled CLEAR III trial. Lancet 2017; 389: 603–611.Google Scholar
Lacut, K, Bressollette, L, Le Gal, G, et al.; VICTORIAh Investigators. Prevention of venous thrombosis in patients with acute intracerebral hemorrhage. Neurology 2005; 65: 865869.Google Scholar
Messé, SR, Sansing, LH, Cucchiara, BL, et al.; CHANT Investigators. Prophylactic antiepileptic drug use is associated with poor outcome following ICH. Neurocrit Care 2009; 11: 3844.Google Scholar
Broderick, JP, Brott, TG, Duldner, JE, Tomsick, T, Huster, G. Volume of intracerebral hemorrhage: a powerful and easy-to-use predictor of 30-day mortality. Stroke 1993; 24: 987993.Google Scholar
Hemphill, JC, Bonovich, DC, Besmertis, L, Manley, GT, Johnston, SC. The ICH score: a simple, reliable grading scale for intracerebral hemorrhage. Stroke 2001; 32: 891897.CrossRefGoogle Scholar
Bailey, RD, Hart, RG, Benavente, O, Pearce, LA. Recurrent brain hemorrhage is more frequent than ischemic stroke after intracranial hemorrhage. Neurology 2001; 56: 773777.Google Scholar
Hanger, HC, Wilkinson, TJ, Fayez-Iskander, N, Sainsbury, R. The risk of recurrent stroke after intracerebral haemorrhage. J Neurol Neurosurg Psychiatry 2007; 78: 836840.Google Scholar
Azarpazhooh, MR, Nicol, MB, Donnan, GA, et al. Patterns of stroke recurrence according to subtype of first stroke event: the North East Melbourne Stroke Incidence Study (NEMESIS). Int J Stroke 2008; 3: 158164.Google Scholar
Zia, E, Engström, G, Svensson, PJ, Norrving, B, Pessah-Rasmussen, H. Three-year survival and stroke recurrence rates in patients with primary intracerebral hemorrhage. Stroke 2009; 40: 35673573.CrossRefGoogle ScholarPubMed
PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6,105 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358: 10331041.CrossRefGoogle Scholar
Greenberg, SM, Eng, JA, Ning, M, Smith, EE, Rosand, J. Hemorrhage burden predicts recurrent intracerebral hemorrhage after lobar hemorrhage. Stroke 2004; 35: 14151420.Google Scholar

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