Updated Guidelines for Treating Spontaneous Intracerebral Hemorrhage

Busting new and old myths on treating ICH.

Highlits on new and revised reccomendation in patients presenting with Spontaneous Intracerebral Hemorrage (ICH).

Safety of Early Intensive BP-Lowering Treatment

For ICH patients presenting with SBP between 150 and 220 mm Hg and without contraindication to acute BP treatment, acute lowering of SBP to 140 mm Hg is safe (Class I; Level of Evidence A) and can be effective for improving functional outcome (Class IIa; Level of Evidence B) (Revised from the previous guideline)
For ICH patients presenting with SBP >220 mm Hg, it may be reasonable to consider aggressive reduction of BP with a continuous intravenous infusionand frequent BP monitoring (Class IIb; Level of Evidence C). (New recommendation)

Because the speed and degree of BP reduction will vary according to the agent and method of delivery (bolus versus infusion) and clinical features, the choice of agent should take into account the practicability, pharmaco logical profile, potential side effects, and cost.

Glucose Management: Recommendation

Glucose should be monitored. Both hyperglycemia and hypoglycemia should be avoided (Class I; Level of Evidence C).(Revised from the previous guideline)

Temperature Management

Treatment of fever after ICH is reasonable

Seizures and Antiseizure Drugs Recommendations

Clinical seizures should be treated with antiseizure drugs (Class I; Level of Evidence A). (Unchanged from the previous guideline)
Prophylactic antiseizure medication is not recommended (Class III; Level of Evidence B). (Unchanged from the previous guideline)

ICP Monitoring and Treatment: Recommendations

Corticosteroids should not be administered for treatment of elevated ICP in ICH (Class III; Level of Evidence B). (New recommendation)

Those are just few of many changes introduced in this revision of the Guidelines. Discover more!

You can find the link to download the full text of this (and may other) guidelines on MEDEST at:

Guidelines page

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