Intracerebral Hemorrhage.
Review published in Continuum (Minneapolis, Minn.) (2021)
Abstract
PURPOSE OF REVIEW: Nontraumatic intracerebral hemorrhage (ICH) is the second most common type of stroke. This article summarizes the basic pathophysiology, classification, and management of ICH and discusses the available evidence on therapy for hematoma, hematoma expansion, and perihematomal edema. RECENT FINDINGS: Current available data on potential therapeutic options for ICH are promising, although none of the trials have shown improvement in mortality rate. The literature available on reversal of anticoagulation and antiplatelet agents after an ICH and resumption of these medications is also increasing. SUMMARY: ICH continues to have high morbidity and mortality. Advances in therapeutic options to target secondary brain injury from the hematoma, hematoma expansion, and perihematomal edema are increasing. Data on reversal therapy for anticoagulant-associated or antiplatelet-associated ICH and resumption of these medications are evolving.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Nontraumatic intracerebral hemorrhage (ICH) is the second most common type of stroke. This article summarizes the basic pathophysiology, classification, and management of ICH and discusses the available evidence on therapy for hematoma, hematoma expansion, and perihematomal edema. Current available data on potential therapeutic options for ICH are promising, although none of the trials have shown improvement in mortality rate.
Why This Matters for Hirudotherapy
This review summarizes the pathophysiology, classification, and management of nontraumatic intracerebral hemorrhage (ICH), the second most common stroke type, and surveys evolving evidence on treating the hematoma, hematoma expansion, and perihematomal edema, as well as reversal of anticoagulant- or antiplatelet-associated ICH and the question of resuming these medications; it notes that current therapeutic options are promising but that no trial has shown improved mortality. For ASH the value is contextual: it details the bleeding-side risk that defines the safety envelope for all anticoagulation, the same envelope relevant to leech-derived antithrombotics within the secretome drug-discovery narrative. As a narrative review it aggregates other studies rather than reporting original results, explicitly describes the evidence as still evolving, and makes no reference to medicinal leeches or hirudotherapy.
Citation
Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026