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Medical management of intracerebral haemorrhage
  1. Floris H B M Schreuder1,
  2. Shoichiro Sato2,3,
  3. Catharina J M Klijn1,4,
  4. Craig S Anderson3,5,6,7
  1. 1Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
  2. 2Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
  3. 3Neurological and Mental Health Division, The George Institute for Global Health Australia, Sydney, New South Wales, Australia
  4. 4Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center, Utrecht, The Netherlands
  5. 5The George Institute for Global Health China, Peking University Health Science Center, Beijing, China
  6. 6Central Clinical School, University of Sydney, Sydney, Australia
  7. 7Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
  1. Correspondence to Professor Craig Anderson, The George Institute for Global Health, Peking University Health Science Center, Beijing, 100088, PR China; canderson{at}


The global burden of intracerebral haemorrhage (ICH) is enormous. Developing evidence-based management strategies for ICH has been hampered by its diverse aetiology, high case fatality and variable cooperative organisation of medical and surgical care. Progress is being made through the conduct of collaborative multicentre studies with the large sample sizes necessary to evaluate therapies with realistically modest treatment effects. This narrative review describes the major consequences of ICH and provides evidence-based recommendations to support decision-making in medical management.


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  • Contributors CSA outlined the review process and contributed particular sections. FHBMS and SS wrote first drafts of particular sections. CJMK wrote particular sections. All authors made comments on the final manuscript and approved submission.

  • Funding CJMK is supported by a clinical established investigator grant of the Dutch Heart Foundation (grant number 2012 T077), and an Aspasia grant from The Netherlands Organisation for Health Research and Development, ZonMw (015008048). CSA holds a Senior Principle Research Fellowship of the National Health and Medical Research Council (NHMRC) of Australia.

  • Competing interests SS reports receiving speaker fees from Otsuka Pharmaceutical and Boehringer Ingelheim. CJMK reports receiving speaker fees from Boehringer Ingelheim and Penumbra, which were paid to the hospital research fund and not to a personal account; and has been site Principal Investigator for a Pfizer-sponsored clinical stroke trial. CSA reports receiving travel reimbursement and speaker fees from Boehringer Ingelheim and Takeda, and Advisory Board sitting fees from AstraZeneca and Medtronic.

  • Provenance and peer review Commissioned; externally peer reviewed.