Intracerebral hemorrhage (ICH) is the second most common type of stroke, accounting for approximately 10-20% of all strokes, and is linked to severe neurological disability and death. Since the most accurate predictor of outcome in patients with ICH is hematoma volume, there is a great need for pharmacologic therapy that can reduce hematoma expansion and resultant mass effect and edema. This is especially critical within the ultra-early window of 3-4 hours after the presentation. Hemostatic therapies are exceptionally important for those patients taking antiplatelet or anticoagulant medications to reverse the effects of these medications and therefore prevent hematoma expansion. Furthermore, the recent publication of the 2023 Guideline for the Management of Patients with Aneurysmal Subarachnoid Hemorrhage by the American Heart Association/American Stroke Association, the first update to the guidelines since 2012, underscores the importance of optimizing anticoagulation reversal for this population. The purpose of this selective, nonsystematic review is to examine current literature regarding the use of hemostatic therapies in ICH, with particular attention paid to antiplatelet, anticoagulation, and antifibrinolytic therapies.

中文翻译：

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急性脑出血的超早期止血治疗：最新综述。

脑出血 (ICH) 是第二常见的中风类型，约占所有中风的 10-20%，并与严重的神经功能障碍和死亡有关。由于 ICH 患者预后最准确的预测因素是血肿量，因此非常需要能够减少血肿扩张以及由此产生的占位效应和水肿的药物治疗。这在演示后 3-4 小时的超早窗口内尤其重要。对于那些服用抗血小板或抗凝药物的患者来说，止血治疗尤为重要，以逆转这些药物的作用，从而防止血肿扩大。此外，美国心脏协会/美国卒中协会最近发布的《2023 年动脉瘤性蛛网膜下腔出血患者管理指南》是该指南自 2012 年以来的首次更新，强调了优化该人群抗凝逆转的重要性。本次选择性、非系统性综述的目的是检查有关 ICH 止血治疗使用的最新文献，特别关注抗血小板、抗凝和抗纤溶治疗。