Medical management of increased intracranial pressure after spontaneous intracerebral hemorrhage

The clinician is frequently faced with the patient who has suffered a spontaneous intracerebral hemorrhage. This article discusses the role of differing modes of intracranial pressure (ICP) management. ICP management can serve as either a primary therapeutic modality or an adjunct to other surgical efforts to control ICP (eg, direct hematoma evacuation). At the heart of all these management strategies is the notion that sustained increased ICP leads to further permanent neurologic injury. Because increased ICP is correlated with an increased volume of intracranial contents, all ICP therapies attempt to reduce the volume occupied by the intracranial contents while preserving maximum tissue perfusion and oxygenation.