Advertisement

Intracerebral Haemorrhage

  • Rohit Bhatia
  • N. Shobha
  • Pablo Garcia Bermejo
  • Dar Dowlatshahi
Chapter

Abstract

Stroke is a leading cause of death and disability worldwide. Spontaneous or non-traumatic intracerebral haemorrhage (ICH) is the commonest of all haemorrhagic strokes [1]. It represents the second most common cause of stroke, with an incidence of 8–15% in Australia, the UK and the USA and 25% in Japan [2]. An overall high incidence of ICH is reported in Asians compared with the Caucasian population [3]. Although ICH occurs less frequently than ischaemic stroke, mortality rates are higher—50% for ICH versus 20% for ischaemic strokes. Depending on the aetiology, ICH can be classified as primary or secondary. Primary ICH, which occurs more frequently (78–88%), is caused by the rupture of a vessel usually degenerated by mechanisms such as hypertension [4] or an underlying amyloid angiopathy. Secondary ICH occurs from other disorders that predispose to bleeding. Predilection sites for ICH include the basal ganglia (40–50%), lobar regions (20–50%), thalamus (10–15%), pons (5–12%), cerebellum (5–10%) and other brain stem sites (1–5%). Intraventricular haemorrhage occurs in approximately one-third of cases of ICH from extension of bleeding into the ventricular space and carries a worse prognosis. The 30-day mortality in ICH is high (35–52%) and is associated with a high morbidity, as only 10% of the patients are independent at 30 days and 20% at 6 months.

References

  1. 1.
    Qureshi AI, Tuhrim S, Broderick JP, et al. Spontaneous intracerebral hemorrhage. N Engl J Med. 2001;344:1450–60.PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    Kimura Y, Takishita S, Muratani H, et al. Demographic study of first-ever stroke and acute myocardial infarction in Okinawa, Japan. Intern Med. 1998;37:736–45.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Taqui A, Kamal AK. Stroke in Asians. Pak J Neurol Sci. 2007;2:14–7.Google Scholar
  4. 4.
    Qureshi AI, Mendelow AD, Hanley DF. Intracerebral hemorrhage. Lancet. 2009;373:1632–44.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Broderick JP, Brott T, Tomsick T, et al. Intracerebral hemorrhage more than twice as common as subarachnoid hemorrhage. J Neurosurg. 1993;78:188–91.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Flaherty ML, Woo D, Haverbusch M, et al. Racial variations in location and risk of intracerebral hemorrhage. Stroke. 2005;36:934–7.PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Lovelock CE, Molyneux AJ, Rothwell PM. Change in incidence and aetiology of intracerebral haemorrhage in Oxfordshire, UK, between 1981 and 2006: a population-based study. Lancet Neurol. 2007;6:487–93.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Zia E, Hedblad B, Pessah-Rasmussen H, et al. Blood pressure in relation to the incidence of cerebral infarction and intracerebral hemorrhage. Hypertensive hemorrhage: debated nomenclature is still relevant. Stroke. 2007;38:2681–5.PubMedCrossRefPubMedCentralGoogle Scholar
  9. 9.
    Thrift AG, McNeil JJ, Forbes A, et al. Three important subgroups of hypertensive persons at greater risk of intracerebral hemorrhage. Melbourne Risk Factor Study Group. Hypertension. 1998;31:1223–9.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Klatsky AL, Armstrong MA, Friedman GD. Alcohol use and subsequent cerebrovascular disease hospitalizations. Stroke. 1989;20:741–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Segal AZ, Chiu RI, Eggleston-Sexton PM, et al. Low cholesterol as a risk factor for primary intracerebral hemorrhage: a case–control study. Neuroepidemiology. 1999;18:185–93.PubMedCrossRefGoogle Scholar
  12. 12.
    Ariesen MJ, Claus SP, Rinkel GJ, et al. Risk factors for intracerebral hemorrhage in the general population: a systematic review. Stroke. 2003;34:2060–5.PubMedCrossRefGoogle Scholar
  13. 13.
    Ritter MA, Droste DW, Hegedüs K, et al. Role of cerebral amyloid angiopathy in intracerebral hemorrhage in hypertensive patients. Neurology. 2005;64:1233–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Bos MJ, Koudstaal PJ, Hofman A, et al. Decreased glomerular filtration rate is a risk factor for hemorrhagic but not for ischemic stroke: the Rotterdam Study. Stroke. 2007;38:3127–32.PubMedCrossRefGoogle Scholar
  15. 15.
    Jackson CA, Sudlow CL. Is hypertension a more frequent risk factor for deep than for lobar supratentorial intracerebral haemorrhage? J Neurol Neurosurg Psychiatry. 2006;77:1244–52.PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Garcia JH, Ho KL. Pathology of hypertensive arteriopathy. Neurosurg Clin N Am. 1992;3:497–507.PubMedCrossRefGoogle Scholar
  17. 17.
    Fisher CM. Pathological observations in hypertensive cerebral hemorrhage. J Neuropathol Exp Neurol. 1971;30:536–50.PubMedCrossRefGoogle Scholar
  18. 18.
    Offenbacher H, Fazekas F, Schmidt R, et al. MR of cerebral abnormalities concomitant with primary intracerebral hematomas. AJNR Am J Neuroradiol. 1996;17:573–8.PubMedGoogle Scholar
  19. 19.
    Cordonnier C, Al-Shahi Salman R, et al. Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting. Brain. 2007;130:1988–2003.PubMedCrossRefGoogle Scholar
  20. 20.
    Zodpey SP, Tiwari RR, Kulkarni HR. Risk factors for haemorrhagic stroke: a case–control study. Public Health. 2000;114:177–82.PubMedGoogle Scholar
  21. 21.
    Dearden NM. Mechanisms and prevention of secondary brain damage during intensive care. Clin Neuropathol. 1998;17:221–8.PubMedGoogle Scholar
  22. 22.
    Rosenberg GA, Navratil M. Metalloproteinase inhibition blocks edema in intracerebral hemorrhage in the rat. Neurology. 1997;48:921–6.PubMedCrossRefGoogle Scholar
  23. 23.
    Brott T, Broderick J, Kothari R, et al. Early hemorrhage growth in patients with intracerebral hemorrhage. Stroke. 1997;28:1–5.CrossRefGoogle Scholar
  24. 24.
    Fujii Y, Takeuchi S, Sasaki O, et al. Multivariate analysis of predictors of hematoma enlargement in spontaneous intracerebral hemorrhage. Stroke. 1998;29:1160–6.PubMedCrossRefGoogle Scholar
  25. 25.
    Barras CD, Tress BM, Christensen S, et al., and for the Recombinant Activated Factor VII Intracerebral Hemorrhage Trial Investigators. Density and shape as CT predictors of intracerebral hemorrhage growth. Stroke. 2009;40:1325–31.Google Scholar
  26. 26.
    Dowlatshahi D, Smith EE, Flaherty ML, et al., on behalf of the VISTA Collaborators. Small intra-cerebral hemorrhages are associated with less hematoma expansion and better outcomes. Int J Stroke. 2011;6:201–6.Google Scholar
  27. 27.
    Yamaki T, Yoshino E, Higuchi T. Extravasation of contrast medium during both computed tomography and cerebral angiography. Surg Neurol. 1983;19:247–50.PubMedCrossRefGoogle Scholar
  28. 28.
    Wolpert SM, Schatzki SC. Extravasation of contrast material in the intracerebral basal ganglia. Radiology. 1972;102:83–5.PubMedCrossRefGoogle Scholar
  29. 29.
    Huckman MS, Weinberg PE, Kim KS, et al. Angiographic and clinico-pathologic correlates in basal ganglionic hemorrhage. Radiology. 1970;95:79–92.PubMedCrossRefGoogle Scholar
  30. 30.
    Murai Y, Ikeda Y, Teramoto A, et al. Magnetic resonance imaging-documented extravasation as an indicator of acute hypertensive intracerebral hemorrhage. J Neurosurg. 1998;88:650–5.PubMedCrossRefPubMedCentralGoogle Scholar
  31. 31.
    Becker KJ, Baxter AB, Bybee HM, et al. Extravasation of radiographic contrast is an independent predictor of death in primary intracerebral hemorrhage. Stroke. 1999;30:2025–32.PubMedCrossRefPubMedCentralGoogle Scholar
  32. 32.
    Wada R, Aviv RI, Fox AJ, et al. CT angiography ‘spot sign’ predicts hematoma expansion in acute intracerebral hemorrhage. Stroke. 2007;38:1257–62.PubMedCrossRefPubMedCentralGoogle Scholar
  33. 33.
    Goldstein JN, Fazen LE, Snider R, et al. Contrast extravasation on CT angiography predicts hematoma expansion in intracerebral hemorrhage. Neurology. 2007;68:889–94.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Thompson AL, Kosior JC, Gladstone DJ, et al PREDICTS/Sunnybrook ICH CTA Study Group. Defining the CT angiography ‘spot sign’ in primary intracerebral hemorrhage. Can J Neurol Sci. 2009;36:456–61.Google Scholar
  35. 35.
    Demchuk AM, Dowlatshahi D, Rodriguez-Luna D, Molina CA, Blas YS, Dzialowski I, Kobayashi A, Boulanger JM, Lum C, Gubitz G, Padma V, Roy J, Kase CS, Kosior J, Bhatia R, Tymchuk S, Subramaniam S, Gladstone DJ, Hill MD, Aviv RI, PREDICT/Sunnybrook ICH CTA study group. Prediction of haematoma growth and outcome in patients with intracerebral haemorrhage using the CT-angiography spot sign (PREDICT): a prospective observational study. Lancet Neurol. 2012;11(4):307–14.PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    David J. Gladstone, Richard I. Aviv, Andrew M. Demchuk, Michael D. Hill, Kevin E. Thorpe, Jane C. Khoury et al. LB16—randomized trial of hemostatic therapy for ‘spot sign’ positive intracerebral hemorrhage: primary results from the SPOTLIGHT/STOP-IT study collaboration. 2017. http://www.abstractsonline.com/pp8/-!/4172/presentation/13152.
  37. 37.
    Andrews BT, Chiles BW, Olsen WL, et al. The effect of intracerebral hematoma location on the risk of brain-stem compression and on clinical outcome. J Neurosurg. 1988;69:518–22.PubMedCrossRefPubMedCentralGoogle Scholar
  38. 38.
    Mayer SA, Sacco RL, Shi T, et al. Neurologic deterioration in noncomatose patients with supratentorial intracerebral hemorrhage. Neurology. 1994;44:1379–84.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Hemphill JC, Bonovich DC, Besmertis L, et al. The ICH score: a simple, reliable grading scale for intracerebral hemorrhage. Stroke. 2001;32:891–7.PubMedCrossRefGoogle Scholar
  40. 40.
    Clarke JL, Johnston SC, Farrant M, et al. External validation of the ICH score. Neurocrit Care. 2004;1:53–60.PubMedCrossRefGoogle Scholar
  41. 41.
    Cheung RT, Zou LY. Use of the original, modified, or new intracerebral hemorrhage score to predict mortality and morbidity after intracerebral hemorrhage. Stroke. 2003;34:1717–22.PubMedCrossRefGoogle Scholar
  42. 42.
    Ruiz-Sandoval JL, Chiquete E, Romero-Vargas S, et al. Grading scale for prediction of outcome in primary intracerebral hemorrhages. Stroke. 2007;38:1641–4.PubMedCrossRefGoogle Scholar
  43. 43.
    Hemphill JC III, Farrant M, Neill TA Jr. Prospective validation of the ICH score for 12-month functional outcome. Neurology. 2009;73:1088–94.PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Zurasky JA, Aiyagari V, Zazulia AR, et al. Early mortality following spontaneous intracerebral hemorrhage. Neurology. 2005;64:725–7.PubMedCrossRefGoogle Scholar
  45. 45.
    Becker KJ, Baxter AB, Cohen WA, et al. Withdrawal of support in intracerebral hemorrhage may lead to self-fulfilling prophecies. Neurology. 2001;56:766–72.PubMedCrossRefGoogle Scholar
  46. 46.
    Rost NS, Smith EE, Chang Y, et al. Prediction of functional outcome in patients with primary intracerebral hemorrhage: The FUNC score. Stroke. 2008;39:2304–9.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Beach MC, Morrison RS. The effect of do-not-resuscitate orders on physician decision-making. J Am Geriatr Soc. 2002;50:2057–61.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    Hemphill JC III, Newman J, Zhao S, et al. Hospital usage of early do-not-resuscitate orders and outcome after intracerebral hemorrhage. Stroke. 2004;35:1130–4.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Morgenstern LB, Hemphill JC III, Anderson C, et al.; on behalf of the American Heart Association Stroke Council and Council on Cardiovascular Nursing. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2010;41:2108–29.Google Scholar
  50. 50.
    Delgado Almandoz JE, Yoo AJ, Stone MJ, et al. Systematic characterization of the computed tomography angiography spot sign in primary intracerebral hemorrhage identifies patients at highest risk for hematoma expansion. The Spot Sign Score. Stroke. 2009;40(9):2994–3000.PubMedPubMedCentralCrossRefGoogle Scholar
  51. 51.
    Delgado Almandoz JE, Yoo AJ, Stone MJ, et al. The spot sign score in primary intracerebral hemorrhage identifies patients at highest risk of in-hospital mortality and poor outcome among survivors. Stroke. 2010;41(1):54–60.PubMedCrossRefGoogle Scholar
  52. 52.
    Brouwers HB, Chang Y, Falcone GJ, Cai X, Ayres AM, Battey TW, Vashkevich A, McNamara KA, Valant V, Schwab K, Orzell SC, Bresette LM, Feske SK, Rost NS, Romero JM, Viswanathan A, Chou SH, Greenberg SM, Rosand J, Goldstein JN. Predicting hematoma expansion after primary intracerebral hemorrhage. JAMA Neurol. 2014;71(2):158–64.PubMedPubMedCentralCrossRefGoogle Scholar
  53. 53.
    Wang X, Arima H, Al-Shahi Salman R, Woodward M, Heeley E, Stapf C, Lavados PM, Robinson T, Huang Y, Wang J, Delcourt C, Anderson CS, INTERACT Investigators. Clinical prediction algorithm (BRAIN) to determine risk of hematoma growth in acute intracerebral hemorrhage. Stroke. 2015 Feb;46(2):376–81.PubMedCrossRefGoogle Scholar
  54. 54.
    Misra UK, Kalita J, Ranjan P, et al. Mannitol in intracerebral hemorrhage: a randomized controlled study. J Neurol Sci. 2005;234:41–5.PubMedCrossRefGoogle Scholar
  55. 55.
    Tan G, Zhou JY, Mao YC, et al. Most effective daily dose and use method of mannitol in patients with cerebral hemorrhage at acute stage. Zhonghua Yi Xue Za Zhi. 2008;88:889–91.PubMedGoogle Scholar
  56. 56.
    Poungvarin N, Bhoopat W, Viriyavejakul A, et al. Effects of dexamethasone in primary supratentorial intracerebral hemorrhage. N Engl J Med. 1987;316:1229–33.PubMedCrossRefGoogle Scholar
  57. 57.
    Tellez H, Bauer R. Dexamethasone as treatment in cerebrovascular disease, 1: a controlled study in intracerebral hemorrhage. Stroke. 1973;4:541–6.PubMedCrossRefGoogle Scholar
  58. 58.
    Yu YL, Kumana CR, Lauder IJ, et al. Treatment of acute cerebral hemorrhage with intravenous glycerol: a double-blind, placebo-controlled, randomized trial. Stroke. 1992;23:967–71.PubMedCrossRefGoogle Scholar
  59. 59.
    Schwab S, Spranger M, Schwarz S, et al. Barbiturate coma in severe hemispheric stroke: useful or obsolete? Neurology. 1997;48:1608–13.PubMedCrossRefGoogle Scholar
  60. 60.
    Aguilar MI, Hart RG, Kase CS, et al. Treatment of warfarin-associated intracerebral hemorrhage: literature review and expert opinion. Mayo Clin Proc. 2007;82:82–92.PubMedCrossRefGoogle Scholar
  61. 61.
    Steiner T, Poli S, Griebe M, Hüsing J, Hajda J, Freiberger A, Bendszus M, Bösel J, Christensen H, Dohmen C, Hennerici M, Kollmer J, Stetefeld H, Wartenberg KE, Weimar C, Hacke W, Veltkamp R. 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(6):566–73.PubMedCrossRefGoogle Scholar
  62. 62.
    Robinson MT, Rabinstein AA, Meschia JF, et al. Safety of recombinant activated Factor VII in patients with warfarin-associated hemorrhages of the central nervous system. Stroke. 2010;41:1459–63.PubMedCrossRefGoogle Scholar
  63. 63.
    Ananthasubramaniam K, Beattie JN, Rosman HS, et al. How safely and for how long can warfarin therapy be withheld in prosthetic heart valve patients hospitalized with a major hemorrhage? Chest. 2001;119:478–84.PubMedCrossRefGoogle Scholar
  64. 64.
    Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–51.CrossRefGoogle Scholar
  65. 65.
    Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–92.CrossRefGoogle Scholar
  66. 66.
    Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365:883–91.CrossRefGoogle Scholar
  67. 67.
    The EINSTEIN–PE Investigators. Oral rivaroxaban for the treatment of symptomatic pulmonary embolism. N Engl J Med. 2012;366:1287–97.CrossRefGoogle Scholar
  68. 68.
    The EINSTEIN Investigators. Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med. 2010;363:2499–510.CrossRefGoogle Scholar
  69. 69.
    Steiner T, Al-Shahi Salman R, et al. European Stroke Organisation (ESO) guidelines for the management of spontaneous intracerebral hemorrhage. Int J Stroke. 2014;9:840–55.PubMedCrossRefGoogle Scholar
  70. 70.
    Dhakal P, Rayamajhi S, Verma V, Gundabolu K, Bhatt VR. Reversal of anticoagulation and management of bleeding in patients on anticoagulants. Clin Appl Thromb Hemost. 2017;23(5):410–5.PubMedCrossRefPubMedCentralGoogle Scholar
  71. 71.
    Tummala R, Kavtaradze A, Gupta A, Ghosh RK. Specific antidotes against direct oral anticoagulants: a comprehensive review of clinical trials data. Int J Cardiol. 2016;214:292–8.PubMedCrossRefPubMedCentralGoogle Scholar
  72. 72.
    Connolly SJ, Crowther M, Eikelboom JW, Gibson CM, Curnutte JT, Lawrence JH, Yue P, Bronson MD, Lu G, Conley PB, Verhamme P, Schmidt J, Middeldorp S, Cohen AT, Beyer-Westendorf J, Albaladejo P, Lopez-Sendon J, Demchuk AM, Pallin DJ, Concha M, Goodman S, Leeds J, Souza S, Siegal DM, Zotova E, Meeks B, Ahmad S, Nakamya J, Milling TJ Jr; ANNEXA-4 Investigators. Full Study Report of Andexanet Alfa for Bleeding Associated with Factor Xa Inhibitors. N Engl J Med. 2019 Feb 7. doi: 10.1056/NEJMoa1814051. [Epub ahead of print]Google Scholar
  73. 73.
    Yates SW. Interrupting anticoagulation in patients with nonvalvular atrial fibrillation. P T. 2014;39:858–64.PubMedPubMedCentralGoogle Scholar
  74. 74.
    Wakefield TW, Stanley JC. Intraoperative heparin anticoagulation and its reversal. Semin Vasc Surg. 1996;9:296–302.PubMedPubMedCentralGoogle Scholar
  75. 75.
    Mannucci PM, Remuzzi G, Pusineri F, et al. Deamino-8-D-arginine vasopressin shortens the bleeding time in uremia. N Engl J Med. 1983;308:8–12.PubMedCrossRefPubMedCentralGoogle Scholar
  76. 76.
    National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333:1581–7.CrossRefGoogle Scholar
  77. 77.
    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;358:2127–37.Google Scholar
  78. 78.
    Mayer SA, Davis SM, Skolnick BE, et al. FAST trial investigators. Can a subset of intracerebral hemorrhage patients benefit from hemostatic therapy with recombinant activated factor VII? Stroke. 2009;40:833–40.PubMedCrossRefPubMedCentralGoogle Scholar
  79. 79.
    Yuan ZH, Jiang JK, Huang WD, et al. A meta-analysis of the efficacy and safety of recombinant activated factor VII for patients with acute intracerebral hemorrhage without hemophilia. J Clin Neurosci. 2010;17:685–93.PubMedCrossRefPubMedCentralGoogle Scholar
  80. 80.
    Broderick JP, Adams HP Jr, Barsan W, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 1999;30:905–15.PubMedCrossRefGoogle Scholar
  81. 81.
    Powers WJ, Zazulia AR, Videen TO, et al. Autoregulation of cerebral blood flow surrounding acute (6–22 hours) intracerebral hemorrhage. Neurology. 2001;57:18–24.PubMedCrossRefGoogle Scholar
  82. 82.
    Anderson CS, Huang Y, Wang JG, et al.; INTERACT Investigators. Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial. Lancet Neurol. 2008;7:391–9.Google Scholar
  83. 83.
    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(25):2355–65.Google Scholar
  84. 84.
    Qureshi AI, Palesch YY, Martin R, Novitzke J, Cruz-Flores S, Ehtisham A. Effect of systolic blood pressure reduction on hematoma expansion, perihematomal edema, and 3-month outcome among patients with intracerebral hemorrhage: results from the antihypertensive treatment of acute cerebral hemorrhage study. Arch Neurol. 2010;67(5):570–6.PubMedPubMedCentralCrossRefGoogle Scholar
  85. 85.
    Qureshi AI, Palesch YY, Barsan WG, Hanley DF, Hsu CY, Martin RL, Moy CS, Silbergleit R, Steiner T, Suarez JI, Toyoda K, Wang Y, Yamamoto H, Yoon BW, ATACH-2 Trial Investigators and the Neurological Emergency Treatment Trials Network. Intensive blood-pressure lowering in patients with acute cerebral hemorrhage. N Engl J Med. 2016;375(11):1033–43.PubMedPubMedCentralCrossRefGoogle Scholar
  86. 86.
    Gioia LC, Kate M, Dowlatshahi D, et al. Blood pressure management in acute intracerebral hemorrhage: current evidence and ongoing controversies. Curr Opin Crit Care. 2015;21(2):99–106.PubMedCrossRefGoogle Scholar
  87. 87.
    Fogelholm R, Murros K, Rissanen A, et al. Admission blood glucose and short term survival in primary intracerebral haemorrhage: a population based study. J Neurol Neurosurg Psychiatry. 2005;76:349–53.PubMedPubMedCentralCrossRefGoogle Scholar
  88. 88.
    Schwarz S, Hafner K, Aschoff A, et al. Incidence and prognostic significance of fever following intracerebral hemorrhage. Neurology. 2000;54:354–61.PubMedCrossRefGoogle Scholar
  89. 89.
    Rossi S, Zanier ER, Mauri I, et al. Brain temperature, body core temperature, and intracranial pressure in acute cerebral damage. J Neurol Neurosurg Psychiatry. 2001;71:448–54.PubMedPubMedCentralCrossRefGoogle Scholar
  90. 90.
    Passero S, Rocchi R, Rossi S, et al. Seizures after spontaneous supratentorial intracerebral hemorrhage. Epilepsia. 2002;43:1175–80.PubMedCrossRefGoogle Scholar
  91. 91.
    Vespa PM, O’Phelan K, Shah M, et al. Acute seizures after intracerebral hemorrhage: a factor in progressive midline shift and outcome. Neurology. 2003;60:1441–6.PubMedCrossRefGoogle Scholar
  92. 92.
    Rincon F, Mayer SA. Clinical review: critical care management of spontaneous intracerebral hemorrhage. Crit Care. 2008;12:237.PubMedPubMedCentralCrossRefGoogle Scholar
  93. 93.
    Boeer A, Voth E, Henze T, et al. Early heparin therapy in patients with spontaneous intra-cerebral haemorrhage. J Neurol Neurosurg Psychiatry. 1991;54:466–7.PubMedPubMedCentralCrossRefGoogle Scholar
  94. 94.
    Dickmann U, Voth E, Schicha H, et al. Heparin therapy, deep-vein thrombosis and pulmonary embolism after intracerebral hemorrhage. Klin Wochenschr. 1988;66:1182–3.PubMedCrossRefGoogle Scholar

Copyright information

© The Author(s) 2019

Authors and Affiliations

  • Rohit Bhatia
    • 1
  • N. Shobha
    • 2
  • Pablo Garcia Bermejo
    • 3
  • Dar Dowlatshahi
    • 4
  1. 1.Department of NeurologyAll India Institute of Medical SciencesNew DelhiIndia
  2. 2.Bangalore Neuro CentreVagus Superspeciality Hospital, Bhagwan Mahaveer Jain HospitalBangaloreIndia
  3. 3.Department of NeurosciencesHospital Universitari Germans Trias, Universitat Autónoma de BarcelonaBarcelonaSpain
  4. 4.Department of MedicineUniversity of Ottawa, Ottawa Hospital Research InstituteOttawaCanada

Personalised recommendations