Emergency Priorities in the Treatment of Cerebral Hemorrhage: Code-Intracerebral Hemorrhage

Neurol Clin. 2025 Feb;43(1):127-139. doi: 10.1016/j.ncl.2024.07.007. Epub 2024 Oct 15.

Abstract

The focus of acute treatment of intracerebral hemorrhage (ICH) includes acute blood pressure management, prevention of secondary hematoma expansion through anticoagulation reversal, and neurosurgical interventions for select patients. Recent evidence points to ultra-early acute ICH bundles, implementing multiple therapies in parallel, as the most impactful therapy in reducing morbidity and mortality. It is time for widespread implementation of formalized care bundles in ICH, including specific metrics for time to treatment and criteria for neurosurgical therapy. No longer just "Code Stroke," it is time for "Code ICH.".

Keywords: Acute care bundles; Blood pressure; CODE ICH; Hemorrhagic stroke; Intracerebral hemorrhage; Neuroimaging; Stroke.

Publication types

  • Review

MeSH terms

  • Cerebral Hemorrhage* / therapy
  • Humans