Intracerebral Hemorrhage: Treatment and Follow-Up in an Acute Setting

Abstract

Intracerebral hemorrhage, a subtype of stroke, is an emergency condition that causes significant morbidity and mortality. Cranial computed tomography (CT) is the preferred imaging modality in the diagnosis of acute ICH. A poor clinical course in patients is associated with hemorrhage that expands early. Careful identification of the primary mechanism of hemorrhage is essential to optimize management. Imaging modalities such as magnetic resonance imaging (MRI) with and without contrast, MR angiography, and CT angiography are usually used to identify the underlying brain lesions. The treatment process, which begins with initial evaluation and stabilization interventions, involves acute blood pressure management, the use of hemostatic agents, external ventricular drainage (EVD), and interventional and surgical methods such as craniotomy, decompressive craniectomy, and evacuation of hematoma to decrease intracranial pressure. Mannitol or hypertonic saline is usually used to treat cerebral edema. The characteristics of the patient determine the choice of the agent to be used in the anti-edema treatment. In patients developing spontaneous ICH and clinical seizures, antiepileptic drugs are recommended to improve functional outcomes and prevent brain damage caused by prolonged and recurrent seizures. In patients with spontaneous intracerebral hemorrhage, it is recommended to provide care in a special inpatient unit (e.g., stroke) with a multidisciplinary team to improve clinical outcomes and reduce mortality. © 2024 Nova Science Publishers, Inc. All rights reserved.