Continuum (Minneapolis, Minn.) · 2026
Intracerebral Hemorrhage.
СтатьяОбзорПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Ziai Wendy C, Shah Vishank A
Аннотация
OBJECTIVE: This article reviews the most important concepts in primary and secondary prevention of spontaneous intracerebral hemorrhage (ICH), with an update on nuances of recovery and rehabilitation in survivors of ICH.
LATEST DEVELOPMENTS: We are in the era of population-based risk assessment with neuroimaging and other markers, with distinct goals of primary and secondary ICH prevention and a holistic approach to management strategies. It is important to recognize that ICH survivors are not only at higher risk of ICH recurrence but also of arterial ischemic events. Increasing, although still limited, data guide specific practice for the prevention of recurrent hemorrhage and ischemic events after ICH. New data indicate that recovery after ICH is significantly slower than seen in ischemic stroke, with patients demonstrating slow but steady improvement through 1 year postictus, underscoring the importance of long-term supportive care and rehabilitation.
ESSENTIAL POINTS: The treatment of spontaneous ICH remains challenging, although hematoma volume and brain edema are becoming modifiable factors. Long-term favorable outcomes after ICH are possible even for patients with poor initial recovery in the hospital and are often influenced by in-hospital events after the acute phase. Secondary prevention is essential for the patient with ICH and requires an individualized evaluation and treatment approach, balancing the risks of future ICH recurrence with arterial ischemic events. Cognitive decline and mood disorders contribute significantly to health-related quality of life after ICH, in addition to functional impairment, and may require a broad range of interventions.
LATEST DEVELOPMENTS: We are in the era of population-based risk assessment with neuroimaging and other markers, with distinct goals of primary and secondary ICH prevention and a holistic approach to management strategies. It is important to recognize that ICH survivors are not only at higher risk of ICH recurrence but also of arterial ischemic events. Increasing, although still limited, data guide specific practice for the prevention of recurrent hemorrhage and ischemic events after ICH. New data indicate that recovery after ICH is significantly slower than seen in ischemic stroke, with patients demonstrating slow but steady improvement through 1 year postictus, underscoring the importance of long-term supportive care and rehabilitation.
ESSENTIAL POINTS: The treatment of spontaneous ICH remains challenging, although hematoma volume and brain edema are becoming modifiable factors. Long-term favorable outcomes after ICH are possible even for patients with poor initial recovery in the hospital and are often influenced by in-hospital events after the acute phase. Secondary prevention is essential for the patient with ICH and requires an individualized evaluation and treatment approach, balancing the risks of future ICH recurrence with arterial ischemic events. Cognitive decline and mood disorders contribute significantly to health-related quality of life after ICH, in addition to functional impairment, and may require a broad range of interventions.