The Lancet, Volume 373, Issue 9675, Pages 1632 - 1644, 9 May 2009

Dr Adnan I Qureshi MD a , A David Mendelow FRCS b, Daniel F Hanley MD c
a Zeenat Qureshi Stroke Research Center, Department of Neurology and Neurosurgery, University of Minnesota, MN, Minnesota, USA
b Department of Neurosurgery, University of Newcastle, Newcastle, UK
c Division of Brain Injury Outcomes, Johns Hopkins Medical Institutions, Baltimore, MD, USA

Summary
Intracerebral haemorrhage is an important public health problem leading to high rates of death and disability in adults. Although the number of hospital admissions for intracerebral haemorrhage has increased worldwide in the past 10 years, mortality has not fallen. Results of clinical trials and observational studies suggest that coordinated primary and specialty care is associated with lower mortality than is typical community practice. Development of treatment goals for critical care, and new sequences of care and specialty practice can improve outcome after intracerebral haemorrhage. Specific treatment approaches include early diagnosis and haemostasis, aggressive management of blood pressure, open surgical and minimally invasive surgical techniques to remove clot, techniques to remove intraventricular blood, and management of intracranial pressure. These approaches improve clinical management of patients with intracerebral haemorrhage and promise to reduce mortality and increase functional survival.

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