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Updated: Aug 13, 2026

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
09:01

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation

Published on: October 15, 2021

Ultra-early hemostatic therapy for primary intracerebral hemorrhage: a review

Stephan A Mayer1

  • 1Neurological Intensive Care Unit, Columbia-Presbyterian Medical Center, New York, NY, USA.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|February 3, 2006
PubMed

Insights

Recombinant activated factor VII (rFVIIa) reduced hematoma growth in patients with intracerebral hemorrhage (ICH). This ultra-early hemostatic therapy improved outcomes and reduced mortality in non-coagulopathic ICH patients.

Area of Science:

  • Neurology
  • Hematology
  • Critical Care Medicine

Background:

  • Intracerebral hemorrhage (ICH) is a severe stroke type with high mortality and disability.
  • Early hematoma expansion is a primary driver of neurological decline and poor outcomes in ICH patients.
  • Current ICH treatments are limited, highlighting the need for effective early interventions.

Purpose of the Study:

  • To evaluate the efficacy of recombinant activated factor VII (rFVIIa) as an ultra-early hemostatic agent in patients with ICH.
  • To determine if rFVIIa can reduce hematoma growth and improve clinical outcomes in ICH patients.

Main Methods:

  • A Phase-IIB, randomized, double-blind, placebo-controlled, dose-ranging trial involving 399 ICH patients.
  • Patients were treated with rFVIIa or placebo within three hours of ICH onset.
  • Hematoma volume, neurological status, and 30-day mortality were assessed.

Main Results:

  • rFVIIa demonstrated a reduction in hematoma growth in non-coagulopathic ICH patients.
  • Treatment with rFVIIa was associated with reduced 30-day mortality.
  • Improved clinical outcomes were observed at three months in patients treated with rFVIIa.

Conclusions:

  • Ultra-early administration of rFVIIa shows promise as a novel therapy for ICH.
  • rFVIIa may mitigate secondary brain injury by limiting hematoma expansion.
  • These findings have significant implications for neurocritical care management of ICH.

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