Trials in intracerebral haemorrhage: a path to success?

Intracerebral haemorrhage is the most serious and least treatable form of acute stroke.1 It has been particularly challenging to prove that treatments for this condition are safe and effective. Promising treatment targets include attenuation of haematoma growth (eg, with early blood pressure lowering or intravenous tranexamic acid), reduction of intracranial pressure (with surgery), and limiting the toxic effects of breakdown products of the haematoma (eg, via neuroprotection).2 Other approaches under investigation include combined use of medical interventions,3 and use of clinical and imaging biomarkers to identify subgroups of patients at greatest risk of haematoma growth and who would benefit most from treatment.