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Stroke Prevention After Intracerebral Hemorrhage: Where Are We Now?

  • Stroke (DL Tirschwell, Section Editor)
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Abstract

Purpose of Review

Patients after intracerebral hemorrhage (ICH) are at high risk of both ischemic stroke and recurrent ICH, and stroke prevention after ICH is important to improve the long-term outcomes in this patient population. The objective of this article is to review the current guidelines on stroke prevention measures after ICH as well as the new findings and controversies for future guidance.

Recent Findings

Intensive blood pressure reduction might benefit ICH survivors significantly. Cholesterol levels and the risk of ICH have an inverse relationship, but statin therapy after ICH might be still beneficial. Anticoagulation in atrial fibrillation after ICH specifically with novel oral anticoagulants may be associated with better long-term outcomes. Left atrial appendage occlusion may be an alternative for stroke prevention in ICH survivors with atrial fibrillation for whom long-term anticoagulation therapy is contraindicated.

Summary

While complete individualized risk assessment is imperative to prevent stroke after ICH, future research is required to address current controversies and knowledge gap in this topic.

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  1. Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine & Yale New Haven Hospital, 15 York Street, Building LLCI, 10thFloor Suite 1003, P.O. Box 20818, New Haven, CT, 06520, USA

    Hae Young Baang & Kevin N. Sheth

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Dr. Sheth reports grants from Biogen, Novartis, Bard, NIH, and AHA; and personal fees from NControl and Zoll; and non-financial support from Alva.

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Baang, H.Y., Sheth, K.N. Stroke Prevention After Intracerebral Hemorrhage: Where Are We Now?. Curr Cardiol Rep 23, 162 (2021). https://doi.org/10.1007/s11886-021-01594-0

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