2006
DOI: 10.1159/000094831
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Recommendations for the Management of Intracranial Haemorrhage – Part I: Spontaneous Intracerebral Haemorrhage

Abstract: This article represents the recommendations for the management of spontaneous intracerebral haemorrhage of the European Stroke Initiative (EUSI). These recommendations are endorsed by the 3 European societies which are represented in the EUSI: the European Stroke Council, the European Neurological Society and the European Federation of Neurological Societies.

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Cited by 363 publications
(95 citation statements)
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References 361 publications
(237 reference statements)
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“…To adjust for differences in case management, we controlled for aspects of care included in the US and European guidelines for the management of ICH [14, 15]. We operationalized key recommendations according to the following variables: time of first CT scan after symptom onset ≤2 h (as the ability to diagnose ICH early is considered important for patient outcome and reflects the availability of acute stroke care services more generally) (yes/no), admission to stroke unit (yes/no), inpatient and outpatient rehabilitation (number of sessions of physiotherapy, occupational therapy and speech therapy), BP management to control cerebral perfusion pressure (defined as a decrease in BP of 1–20% between first and last BP measurement during the first 24 h after ICH onset) (yes/no), glucose management (defined as blood glucose ≤1.85 g/l at 24 h after ICH onset), medical management of edema (defined by use of the following drugs: mannitol, diuretics, hypertonic solutions) (yes/no), sedation of the patient within the first 5 days of ICH onset to manage intracranial pressure and pain (yes/no), administration of low-weight molecular heparin within the first 48 h of ICH onset for prophylaxis of deep vein thrombosis and pulmonary embolism (yes/no), fever management (defined as a body temperature ≤37.5°C at 24 h after ICH onset), secondary prevention of cardiocerebrovascular disease by use of statins and aspirin at any point during the trial period (yes/no) and prevention of infection by use of antibiotics at any point during the trial period (yes/no).…”
Section: Methodsmentioning
confidence: 99%
“…To adjust for differences in case management, we controlled for aspects of care included in the US and European guidelines for the management of ICH [14, 15]. We operationalized key recommendations according to the following variables: time of first CT scan after symptom onset ≤2 h (as the ability to diagnose ICH early is considered important for patient outcome and reflects the availability of acute stroke care services more generally) (yes/no), admission to stroke unit (yes/no), inpatient and outpatient rehabilitation (number of sessions of physiotherapy, occupational therapy and speech therapy), BP management to control cerebral perfusion pressure (defined as a decrease in BP of 1–20% between first and last BP measurement during the first 24 h after ICH onset) (yes/no), glucose management (defined as blood glucose ≤1.85 g/l at 24 h after ICH onset), medical management of edema (defined by use of the following drugs: mannitol, diuretics, hypertonic solutions) (yes/no), sedation of the patient within the first 5 days of ICH onset to manage intracranial pressure and pain (yes/no), administration of low-weight molecular heparin within the first 48 h of ICH onset for prophylaxis of deep vein thrombosis and pulmonary embolism (yes/no), fever management (defined as a body temperature ≤37.5°C at 24 h after ICH onset), secondary prevention of cardiocerebrovascular disease by use of statins and aspirin at any point during the trial period (yes/no) and prevention of infection by use of antibiotics at any point during the trial period (yes/no).…”
Section: Methodsmentioning
confidence: 99%
“…If recommendations differ for the two conditions, this will be explicitly mentioned; otherwise the recommendations are valid for both conditions. Separate guidelines exist or are being prepared for intracerebral haemorrhage [3] and subarachnoid haemorrhage. The classes of evidence and levels of recommendations used in these guidelines are defined according to the criteria of the European Federation of Neurological Societies (table 1, 2).…”
Section: Forewordmentioning
confidence: 99%
“…Intracerebral hemorrhage (ICH) accounts for approximately 10% of acute strokes and is still associated with a mortality of up to 35–50% [1,2,3]. Several predictors of outcome in ICH have been identified [4,5,6,7].…”
Section: Introductionmentioning
confidence: 99%