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Crit Care Clin. 2014 Oct;30(4):699-717. doi: 10.1016/j.ccc.2014.06.003. Epub 2014 Jul 30.

Critical care management of intracerebral hemorrhage.

Author information

1
Neurocritical Care Program, Department of Neurology, University of California, San Francisco, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
2
Neurocritical Care Program, Department of Neurology, Brain and Spinal Injury Center, San Francisco General Hospital, University of California, San Francisco, Building 1, Room 101, 1001 Potrero Avenue, San Francisco, CA 94110, USA; Department of Neurological Surgery, University of California, San Francisco, 1001 Potrero Avenue, San Francisco, CA 94110, USA. Electronic address: chemphill@sfgh.ucsf.edu.

Abstract

Primary, spontaneous intracerebral hemorrhage (ICH) confers significant early mortality and long-term morbidity worldwide. Advances in acute care including investigative, diagnostic, and management strategies are important to improving outcomes for patients with ICH. Physicians caring for patients with ICH should anticipate the need for emergent blood pressure reduction, coagulopathy reversal, cerebral edema management, and surgical interventions including ventriculostomy and hematoma evacuation. This article reviews the pathogenesis and diagnosis of ICH, and details the acute management of spontaneous ICH in the critical care setting according to existing evidence and published guidelines.

KEYWORDS:

Anticoagulants/adverse effects; Antihypertensive agents/therapeutic use; Blood coagulation disorders; Hypertensive/diagnosis/cause/therapy; Intracerebral hemorrhage; Neurocritical care; Neurosurgical procedures

PMID:
25257736
DOI:
10.1016/j.ccc.2014.06.003
[Indexed for MEDLINE]

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