الفهرس 
PATHOPHYSIOLOGY OF EARLYOnly 14 pages are availabe for public view
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Abstract
Intracerebral hemorrhage (ICH) remains the most lethal form of stroke. Expansion of hematoma occurs in many cases , About 38% of patient had an increase hematoma volume >33% within 3 hours.
Early progression of neurologic deficits and decreased level of consciousness can be expected in 50% of patients with ICH due to enlargement of the hematoma.
Subclinical electroencephalographic seizures occur in up to 30% of patients after ICH, Nonconvulsive seizures are associated with early hematoma growth. Hyperglycemia is associated with increased hematoma volume and expansion and over 50% of patients with stroke have hyperglycemia.Higher cholesterol levels are associated with lesser hemorrhage growth, Adequate cholesterol levels is important for maintaining the integrity of vessels and their resistance to rupture. Blood pressure lowering during acute ICH can reduce hematoma growth and consequently result in better clinical outcomes. Unfortunately, Controversy still exists over the initial BP management in ICH patient.
Ultra-early hemostatic therapy given in the emergency room setting improve outcome after ICH by arresting ongoing bleeding . Studies have failed to show benefit from platelet transfusion in patients with ICH on antiplatelet agents. Oral anticoagulation is usually withheld for between 7 and 10 days after ICH. Minimally Invasive Surgery plus rtPA for Intracerebral hemorrhage Evacuation offers greater clot resolution than conventional medical therapy.