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Priorities for clinical research in intracerebral hemorrhage - Report from a National Institute of Neurological Disorders and Stroke Workshop

Lookup NU author(s): Emeritus Professor David Mendelow


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Background and Purpose-Spontaneous intracerebral hemorrhage (ICH) is one of the most lethal stroke types. In December 2003, a National Institute of Neurological Disorders and Stroke (NINDS) workshop was convened to develop a consensus for ICH research priorities. The focus was clinical research aimed at acute ICH in patients. Methods-Workshop participants were divided into 6 groups: ( 1) current state of ICH research; ( 2) basic science; and ( 3) imaging, ( 4) medical, ( 5) surgical, and ( 6) clinical methodology. Each group formulated research priorities before the workshop. At the workshop, these were discussed and refined. Results-Recent progress in management of hemorrhage growth, intraventricular hemorrhage, and limitations in the benefit of open craniotomy were noted. The workshop identified the importance of developing animal models to reflect human ICH, as well as the phenomena of rebleeding. More human ICH pathology is needed. Real-time, high-field magnets and 3-dimensional imaging, as well as high-resolution tissue probes, are ICH imaging priorities. Trials of acute blood pressure-lowering in ICH and coagulopathy reversal are medical priorities. The exact role of edema in human ICH pathology and its treatment requires intensive study. Trials of minimally invasive surgical techniques including mechanical and chemical surgical adjuncts are critically important. The methodologic challenges include establishing research networks and a multi-specialty approach. Waiver of consent issues and standardizing care in trials are important issues. Encouragement of young investigators from varied backgrounds to enter the ICH research field is critical. Conclusions-Increasing ICH research is crucial. A collaborative approach is likely to yield therapies for this devastating form of brain injury.

Publication metadata

Author(s): Morgenstern LB, Woodbury-Harris K, Marler JR, NINDS ICH Workshop Participants

Publication type: Review

Publication status: Published

Journal: Stroke

Year: 2005

Volume: 36

Issue: 3

Pages: E23-E41

ISSN (print): 0039-2499

ISSN (electronic): 1524-4628


DOI: 10.1161/01.STR.0000155685.77775.4c