Related Experiment Video
Updated: Sep 16, 2026

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
The Effect of Intensive Blood Pressure Reduction on Perihematomal Edema After Intracerebral Hemorrhage: A Systematic
Xianxian Li1, Chengguang Zou1, Yuchao Jia1
1Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Background:
Perihematomal edema (PHE) is a radiological marker of intracerebral hemorrhage (ICH)-induced secondary brain injury. Whether intensive blood pressure (BP) reduction attenuates PHE expansion remains uncertain. We conducted a systematic review and meta-analysis to assess the effect of intensive BP reduction on approximately 24-h PHE expansion in patients with spontaneous ICH.
Methods:
MEDLINE, Embase, and the Cochrane Library were searched from database inception to January 2026. Eligible studies compared intensive versus standard BP reduction in patients with spontaneous ICH and reported PHE-related outcomes. Risk of bias was assessed using the Cochrane risk-of-bias tool. Pooled estimates were calculated using the inverse-variance method with a fixed-effect model.
Results:
Six studies were included in the qualitative synthesis, and 4 studies were included in the quantitative meta-analysis, comprising 1061 patients in the intensive BP reduction group and 966 patients in the standard BP management group. Intensive BP reduction was associated with smaller approximately 24-h PHE expansion than standard BP management (mean difference, -0.50 mL; 95% CI, -0.89 to -0.12; p = 0.010). No statistical heterogeneity was observed (I2 = 0%).
Conclusions:
Intensive BP reduction was associated with smaller approximately 24-h PHE expansion in patients with spontaneous ICH. Further standardized studies are needed to confirm the clinical relevance of this effect.
Related Concept Videos
Cerebral Edema ll: Pathophysiology
Hemorrhagic Stroke ll: Pathophysiology
Cerebral Edema l: Introduction
Increased Intracranial Pressure l: Introduction
Hemorrhagic Stroke l: Introduction
Increased Intracranial Pressure ll: Pathophysiology
