Haemostatic therapy for intracerebral haemorrhage

In recent years, spontaneous intracerebral hoemorrhage (ICH) gains more and more interest within stroke research and becomes a major focus of clinical studies. Among others, two multi-centre, randomized, controlled trials were crucial for this development. Both have been published early in 2005: The International Surgical Trial in Intracerebral Haemorrhage (STICH), and the trial investigating recombinant activated factor VII. Both studies are based on the pathophysiological concept of improving the clinical course by reducing the size of the intracerebral hoematoma, either by surgical removal or by pharmacological reduction of hoematoma growth. We summarize the most important etiologic and pathophysiologic background of haemostatic treatment of ICH and shortly mention oral anticoagulation treatment (OAT)-related ICH. Finally, we discuss the consequences for future therapy and clinical trials.