Management of spontaneous nontraumatic intracranial hemorrhage

J Pharm Pract. 2010 Oct;23(5):398-407. doi: 10.1177/0897190010372320. Epub 2010 Aug 2.

Abstract

Intracerebral hemorrhage (ICH) is one of the most devastating subtypes of stroke and is characterized by spontaneous extravasation into the parenchymal tissue of the brain. Although advances in critical care have improved, there is no intervention currently available that has shown to alter the outcome of patients who have suffered acute ICH. Therefore, management is largely supportive. Treatment strategies are aimed at limiting hematoma enlargement, seizures, and cerebral edema, as well as other ICU-related complications such as deep venous thrombosis, hyperglycemia, and fever. This review will outline the key pharmacological management strategies in patients with ICH and highlight the most current American Heart Association/American Stroke Association (AHA/ASA) guidelines for management published in 2007.

Publication types

  • Review

MeSH terms

  • Animals
  • Anticoagulants / pharmacology
  • Anticoagulants / therapeutic use
  • Blood Pressure / drug effects
  • Blood Pressure / physiology
  • Brain Injuries* / diagnosis
  • Brain Injuries* / physiopathology
  • Brain Injuries* / therapy
  • Disease Management
  • Factor VIIa / pharmacology
  • Factor VIIa / therapeutic use
  • Fibrinolytic Agents / pharmacology
  • Fibrinolytic Agents / therapeutic use
  • Hematoma / diagnosis
  • Hematoma / physiopathology
  • Hematoma / therapy
  • Humans
  • Hypertension / diagnosis
  • Hypertension / physiopathology
  • Hypertension / therapy
  • Intracranial Hemorrhages / diagnosis*
  • Intracranial Hemorrhages / physiopathology
  • Intracranial Hemorrhages / therapy*
  • Randomized Controlled Trials as Topic / methods
  • Recombinant Proteins / pharmacology
  • Recombinant Proteins / therapeutic use

Substances

  • Anticoagulants
  • Fibrinolytic Agents
  • Recombinant Proteins
  • recombinant FVIIa
  • Factor VIIa