ArticleInternational journal of stroke : official journal of the International Stroke Society2020
Treatment of intracerebral hemorrhage: From specific interventions to bundles of care.
Article in International journal of stroke : official journal of the International Stroke Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Relationship between stress hyperglycaemic ratio (SHR) and critical illness: a systematic review.Cardiovascular diabetology · 2025Pooled it
- Neutrophil-to-lymphocyte ratio, white blood cell, and C-reactive protein predicts poor outcome and increased mortality in intracerebral hemorrhage patients: a meta-analysis.Frontiers in neurology · 2023Pooled it
- Patient's care bundle benefits to prevent stroke associated pneumonia: A meta-analysis with trial sequential analysis.Frontiers in neurology · 2022Pooled it
- Outcomes of Intracranial Haemorrhage in Patients Taking Direct Oral Anticoagulants or Vitamin K Antagonists: A Seven-Year Single-Centre Retrospective Analysis.Clinics and practice · 2026Article
- Intracerebral Hemorrhage in Aging: Pathophysiology, Clinical Challenges, and Future Directions.Life (Basel, Switzerland) · 2025Review
- How far are we from bringing intensive care bundle for intracerebral hemorrhage into the real-world setting? A 5-year population based-study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Exploring the associations of gut microbiota with inflammatory and the early hematoma expansion in intracerebral hemorrhage: from change to potential therapeutic objectives.Frontiers in cellular and infection microbiology · 2025Article
- Time for "Code ICH"? Workflow Metrics of Hyperacute Treatments and Outcome in Patients with Intracerebral Haemorrhage.Cerebrovascular diseases (Basel, Switzerland) · 2024Article
- The impact of hospital presentation time on stroke outcomes: A nationally representative Irish cohort study.PloS one · 2024Article
- Andexanet Alfa to Reverse the Effect of Factor Xa Inhibitors in Intracranial Hemorrhage.CNS drugs · 2023Review
- Standard operating procedure for idarucizumab reversal of dabigatran anticoagulation in ischemic and hemorrhagic stroke.Journal of thrombosis and thrombolysis · 2023Review
- Antithrombotic Treatment, Prehospital Blood Pressure, and Outcomes in Spontaneous Intracerebral Hemorrhage.Journal of the American Heart Association · 2023Observational
- Hyperacute prediction of functional outcome in spontaneous intracerebral haemorrhage: systematic review and meta-analysis.European stroke journal · 2022Review
- Development and validation of a nomogram to predict the 30-day mortality risk of patients with intracerebral hemorrhage.Frontiers in neuroscience · 2022Article
- The stress hyperglycemia ratio predicts early hematoma expansion and poor outcomes in patients with spontaneous intracerebral hemorrhage.Therapeutic advances in neurological disorders · 2022Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 3 countries.
Funding
Abstract
Intracerebral hemorrhage (ICH) represents a major, global, unmet health need with few treatments. A significant minority of ICH patients present taking an anticoagulant; both vitamin-K antagonists and increasingly direct oral anticoagulants. Anticoagulants are associated with an increased risk of hematoma expansion, and rapid reversal reduces this risk and may improve outcome. Vitamin-K antagonists are reversed with prothrombin complex concentrate, dabigatran with idarucizumab, and anti-Xa agents with PCC or andexanet alfa, where available. Blood pressure lowering may reduce hematoma growth and improve clinical outcomes and careful (avoiding reductions ≥60 mm Hg within 1 h), targeted (as low as 120-130 mm Hg), and sustained (minimizing variability) treatment during the first 24 h may be optimal for achieving better functional outcomes in mild-to-moderate severity acute ICH. Surgery for ICH may include hematoma evacuation and external ventricular drainage to treat hydrocephalus. No large, well-conducted phase III trial of surgery in ICH has so far shown overall benefit, but meta-analyses report an increased likelihood of good functional outcome and lower risk of death with surgery, compared to medical treatment only. Expert supportive care on a stroke unit or critical care unit improves outcomes. Early prognostication is difficult, and early do-not-resuscitate orders or withdrawal of active care should be used judiciously in the first 24-48 h of care. Implementation of acute ICH care can be challenging, and using a care bundle approach, with regular monitoring of data and improvement of care processes can ensure consistent and optimal care for all patients.
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Registered trials
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