Intracerebral haemorrhage (ICH): general medical management

Evidence-based neurology checklist on intracerebral haemorrhage (ich): general medical management: Blood pressure treatment This is started as soon possible after onset of ICH Aim for mean systolic BP of 130-139mmHg in the first 24 hours Long term aim is blood pressure <130/80mmHg Agents:…

Blood pressure treatment

  • This is started as soon possible after onset of ICH
  • Aim for mean systolic BP of 130-139mmHg in the first 24 hours
  • Long term aim is blood pressure <130/80mmHg
  • Agents: Labetolol, Esmolol, Nicardipine, Enalaprilat, Fenoldopam

Seizure management

Prevent deep vein thrombosis (DVT)

Other treatments

Precautions

Investigational treatments

References

  1. Morgenstern LB, Hemphill III JC, Anderson C, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Strike Association. Stroke 2010; 41:2108-2129.
  2. Mayer SA, Chong J. Critical care management of increased intracranial pressure. J Int Care Med 2002; 17: 55-67.
  3. Greenberg SM, Ziai WC, Cordonnier C, et al. 2022 guideline for the management of patients with spontaneous intracerebral hemorrhage: a guideline from the American Heart Association/American Stroke Association. Stroke 2022; 53:e282-e361.
  4. Burroughs-Ray DC, VanDillen AF, Jackson CD. Clinical guideline highlights for the hospitalist: 2022 American Heart Association/American Stroke Association Guideline for the management of patients with spontaneous intracerebral hemorrhage. J Hosp Med 2023; 18:624-626. 
  5. Rincon F, Mayer SA. Clinical review: critical care management of spontaneous intracerebral hemorrhage. Critical Care 2008; 12:237.
  6. And 3 more. Subscribe to see the full list

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