Many strategies widely considered "standard care" for managing spontaneous intracerebral hemorrhage (ICH) are not as effective as previously thought and are no longer recommended in updated guidelines from the American Heart Association (AHA)/American Stroke Association (ASA).
Compression stockings, antiseizure medication, and steroid treatment are among the treatments with uncertain effectiveness, the writing group says.
The 2022 Guideline for the Management of Patients With Spontaneous ICH was published online May 17 in Stroke. The 80-page document contains major changes and refinements to the 2015 guideline on ICH management.
"Advances have been made in an array of fields related to ICH, including the organization of regional health care systems, reversal of the negative effects of blood thinners, minimally invasive surgical procedures and the underlying disease in small blood vessels," Steven M. Greenberg, MD, PhD, chair of the guideline writing group with Harvard Medical School and Massachusetts General Hospital, Boston, said in a news release.
"We've updated sections across the board. There's probably no area that went untouched with some tweaking and new evidence added that led to some changes in level of evidence or strength of a recommendation," Greenberg added in an interview with theheart.org | Medscape Cardiology.
"Each section comes with knowledge gaps, and it wasn't hard to come up with knowledge gaps in every section," Greenberg acknowledged.
