Acute Management of Spontaneous Intracerebral Hemorrhage

Spontaneous intracerebral hemorrhage is defined as bleeding into the brain parenchyma that is nontraumatic. It has a high rate of morbidity and mortality with death in about 40% of patients within the first 30 days. Prompt recognition of clinical symptoms is needed in the acute setting to initiate management. The mainstay of treatment is lowering blood pressure, reversing anticoagulation, and decreasing intracranial pressure. Surgery may be considered in a select patient population. Prognosis is based on multiple clinical and radiologic findings, but can be supported by the ICH score. Further research is needed to determine effective measures to improve long term outcomes