Prevention of Recurrent Intracerebral Hemorrhage

  • Chirantan BanerjeeEmail author
  • Bruce Ovbiagele


The incidence of intracerebral hemorrhage (ICH) has remained unchanged in the last few decades and continues to carry high morbidity and mortality. However, limited data are available on the occurrence of recurrent ICH, in particular, how best to prevent it. Of note, survivors of an initial ICH are at elevated risk of both recurrent ICH and ischemic stroke, which necessitates that the potential benefits and hazards of antithrombotic (antiplatelet and anticoagulant) drugs be carefully considered in these high-risk patients. In view of the relative paucity of prospectively generated data, including dedicated clinical trials, current strategies for secondary prevention of ICH are primarily informed by retrospective analyses, as well as extrapolation from primary ICH and secondary stroke prevention studies. This review summarizes the current data on risk of ICH recurrence, risk factors associated with an increased risk of ICH recurrence, as well as management of antithrombotics, statins, and other modifiable risk factors in the context of avoiding recurrent ICH.


Prevention Recurrent Intracerebral hemorrhage Antithrombotics Anticoagulants Antiplatelets Hypertension Amyloid angiopathy 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurologyMedical University of South CarolinaCharlestonUSA
  2. 2.University of California, San Francisco Medical CenterSan FranciscoUSA

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