Spontaneous Intracerebral Haemorrhage: A Practical Guide to Diagnosis and Management

We present a topical review intended to update on the pathophysiology, investigation and management of intracerebral haemorrhage (ICH). Recent advances in the field have refined our knowledge of managing ICH and, when implemented, can significantly improve patient outcomes. The aim of this article is to describe the common causes of acute ICH that might be encountered in accident and emergency departments or hyperacute stroke units, and to discuss investigation and management. Reading this article will give the reader confidence in establishing the diagnosis of ICH, starting the investigation pathway and instigating evidence-based acute management to significantly improve outcomes across the United Kingdom. We have included case vignettes with neuroradiology expert opinion on imaging of more commonly found aetiologies of intracerebral haemorrhage. Neurosurgical management is also discussed in addition to medical management, with the limits to knowledge elucidated.