+ A randomized trial showing improved outcomes with tight glucose control (range 80 to 110 mg/dL) using insulin infusions in mainly surgical critical care patients.+ However, more recent studies have demonstrated increased incidence of systemic and cerebral hypoglycemic events and possibly even increased risk of mortality in patients treated with this regimen+ At present the optimal management of hyperglycemia in ICH and the target glucose remains to be clarified. Hypoglycemia should be avoided.
+ Prophylactic anticonvulsant medication should not be used. Class III; Level of Evidence: B+ In prospective and population-based studies, clinical seizures have not been associated with worsened neurological outcome or mortality.+ patients who received antiepileptic drugs (primarily phenytoin) without a documented seizure were significantly more likely to be dead or disabled at 90 days
+ 因ICH引起腦室阻塞(ventricular obstruction) 引起之水腦症(hydrocephalus)和/或腦幹壓迫 因盡速做手術將clot移除。 Level B+ 腦室引流(Ventricular drainage) as treatment for hydrocephalus is reasonable in patients with decreased level of consciousness. Class IIa; Level of Evidence: B
+ 急性ICH血壓要控制好，尤其是那些Patient ICH是典型 的門脈高壓性血管病變(hypertensive vasculopathy)。 Level A
+ In patients presenting with a systolic BP of 150 to 220 mm Hg, acute lowering of systolic BP to 140 mm Hg is probably safe. Class IIa; Level of Evidence: B+ After the acute ICH period, a goal target of a normal BP of <140/90 (<130/80 if diabetes or chronic kidney disease) is reasonable. Class IIa; Level of Evidence: B
+ Intravenous mannitol is the treatment of choice to lower increased intracranial pressure, effectively lowering ICP and benefiting brain metabolism. It is administered as an initial bolus of 1 g/kg, followed by infusions of 0.25 to 0.5 g/kg every six hours.+ The goal of therapy is to achieve plasma hyperosmolality (300 to 310 mosmol/kg) while maintaining an adequate plasma volume; major side effects include hypovolemia and a hyperosmotic state
+ 酒要避免 Class IIa; Level of Evidence: B+ 對有自發性腦葉(spontaneous lobar)的ICH病 患如要治療非瓣膜性心房纖維性顫動 (nonvalvular atrial fibrillation)不要長期地去 使用抗凝血藥物，會提高復發率。 Class IIa; Level of Evidence: B+ 出院後越早做復健越好 Class IIa; Level of Evidence: B