Conclusion

To generate clinically useful data for the proper medical care of patients with ICH, the NINDS workshop has recently defined three areas of clinical research as imperative (3): the careful evaluation of blood pressure goals in acute ICH, determination of the best approach to reversing antithrombotic-induced coagulopathy, and assessment of therapies to limit cerebral edema. Studies that address these clinical questions are currently being conducted.

Some other areas of clinical research interest, as suggested in the NINDS workshop report, are as follows:

  • Identification of appropriate glycemic targets in hemorrhagic stroke
  • Assessment of the clinical impact on outcomes that prophylactic, antiepileptic drug administration has in this patient population
  • Safety of standard forms of DVT prophylaxis
  • Further research in the field of management of hemostatic agents that are specifically directed toward coagulopathy-associated ICH
  • Determination of whether normalization of body temperature or induction of hypothermia translates to improved functional outcome. Identification of the best strategy by which to lower core body temperature in these patients should then follow.

It is hoped that future research in these areas will provide the clinician with sufficient data to make clinically directed decisions in patients with ICH. Until then, those who treat patients with this form of stroke will rely on the limited clinical research available and, more importantly, common sense.

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