Key Terms: ICH, blood pressure control, spot sign
Hosts: Phavalan Rajendram, Neha Patel, Houman Khosravani
Summary:

Hemorrhagic strokes (HS) account for ~15-20% of all strokes

There is a significant morbidity and mortality associated with HS

Early blood pressure control is key in the management of HS

CTA can identify a spot sign (may indicate increased risk of hematoma expansion)

Etiologies

Find out if the patient is on anticoagulation so that it can be reversed

Make sure the patient is stable before CT scan (may need anti-emetics, intubation, etc.)

Early blood pressure control is key

Blood pressure target < 140/90


See ATACH-2 and INTERACT trials on BP control in ICH



Consult NSx early as surgical options may be available


See STICH-2 trial on surgical management of superficial ICH without IVH



Prognostication can be aided with “ICH Score”