Related Experiment Video

Updated: Aug 8, 2026

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
09:01

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation

Published on: October 15, 2021

Update on intracerebral haemorrhage

José M Ferro1

  • 1Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa 1649-035, Portugal. jmferro@fm.ul.pt

Journal of Neurology
|May 9, 2006
PubMed

Insights

Intracerebral haemorrhage (ICH) is a severe stroke type with high mortality. While some treatments show promise, surgery offers no benefit over conservative care for acute ICH.

Area of Science:

  • Neurology
  • Neurosurgery
  • Cardiovascular Medicine

Background:

  • Intracerebral haemorrhage (ICH) is a critical cerebrovascular disease with higher mortality than ischemic stroke.
  • Hypertension is a primary risk factor, increasing ICH risk fourfold.
  • MRI markers like microbleeds and white matter changes indicate ICH risk.

Purpose of the Study:

  • To review the pathophysiology and current treatment strategies for intracerebral haemorrhage.
  • To evaluate the efficacy and safety of interventions aimed at limiting haematoma growth and improving patient outcomes.

Main Methods:

  • Review of pathophysiological phases of ICH, including haematoma formation, enlargement, and oedema.
  • Analysis of randomized clinical trials (RCTs) investigating treatments such as recombinant activated Factor VIIa (rFVIIa) and surgical interventions.
  • Consideration of adjunctive therapies like ventricular drainage with thrombolytics for intraventricular bleeding.

Main Results:

  • rFVIIa limited haematoma growth and improved outcomes but increased thromboembolic complications.
  • Surgical intervention for acute ICH has not demonstrated benefits over conservative management in large trials and meta-analyses.
  • Ventricular drainage with thrombolytics may benefit patients with intraventricular bleeding.

Conclusions:

  • ICH is a devastating condition with poor functional independence rates.
  • Current evidence does not support surgical intervention for acute ICH.
  • Further research into effective treatments for ICH, particularly concerning haematoma expansion and secondary injury, is warranted.

More Related Videos

Intracranial Pressure Monitoring In Nontraumatic Intraventricular Hemorrhage Rodent Model08:18

Intracranial Pressure Monitoring In Nontraumatic Intraventricular Hemorrhage Rodent Model

Published on: February 8, 2022

Related Concept Videos

Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...