Purpose of Review
The present review will cover most recent and important studies on acute treatment of intracerebral hemorrhage (ICH).Recent Findings
Overly pessimistic prognostication in ICH may deny meaningful recovery achieved by specialized neurocritical care. Hematoma enlargement represents the most important target of acute ICH care, which is reduced by aggressive blood pressure management (targeting a systolic blood pressure of 140 mmHg) and appropriate hemostatic treatment especially in anticoagulation-associated ICH (INR reversal using prothrombin complex concentrates, eventually idarucizumab, andexanet, or tranexamic acid). Surgical treatment strategies involving fibrinolytics either used for direct hematoma lysis or used for intraventricular clot removal with/without additional lumbar drainage show great promise. Further novel treatment strategies are underway and need validation or evaluation strongly warranting well-designed future ICH research.Summary
Several randomized and large-sized observational studies have considerably expanded the field and the evidence on how to treat acute ICH patients. Yet, the one breakthrough intervention to improve functional outcome is still missing, though various treatment concepts possibly interacting with one another have been evaluated and such treatment bundle may improve patients’ outcome.Clinical or methodological significance of this article: This article extends previous research in the field of psychotherapeutic change by providing results from the modeling of change trajectories in psychotherapeutic treatments with larger amounts of sessions (i.e., more than 20 sessions). Our findings of domain-specific different shapes (i.e., log-linear for Well-Being and Symptoms and linear for Interpersonal functioning) and speed (i.e., fastest for Well-Being and slowest for Interpersonal function) of trajectories of psychotherapeutic change may be clinically applied by means of guidelines for therapists to plan and adapt their treatments. In addition to content-related aspects of a continuous adjustment of treatment goals (e.g., merely symptom-oriented or focusing on interpersonal change) and interventions, this adaptive planning is also related to health care considerations (e.g., may justify longer treatments if therapy goals target several domains of change). 相似文献