Predicting Intracerebral Hemorrhage

Intracerebral hemorrhage (ICH), while its mechanisms are still poorly understood, is the most fatal form of stroke and is defined as spontaneous bleeding into the brain tissue. Recent improvements in the field of ICH have been made considering the diagnosis of cerebral amyloid angiopathy (CAA) during life, the accurate detection of microbleeds, the association of several genes with CAA-related ICH, and between CAA and warfarin-related ICH, the development of new hemostatic treatments, and the combination of minimally invasive surgery with hematoma thrombolysis. Currently, recommended management for ICH patients is centered on the prompt diagnosis of the patient, on the consideration of early surgery, and on early treatment of coagulopathies and other neurologic complications. Several major randomized studies in ICH have been conducted in the last years and yielded rather unconvincing results. On another hand, increasing data points to an important genetic component considering ICH susceptibility. Identification of ICH and CAA-related genes will therefore be useful to develop treatments for these newly identified targets for ICH prevention. Therefore, with the recent publication of several very promising studies in the field of ICH, and the current lack of effective treatment, the need to consider the synthesis of the underlying data into new knowledge for stroke prediction and prevention has never been more important, especially with the aging of the population.

For this Research Topic volume, we thus ask leader from several fields related to intracerebral hemorrhage and in particular considering the themes of risk factors, genetics and genomics, to provide their thoughts on methods for efficient detection and prevention of ICH, and to discuss their work in exploring the richness of the stroke field, as well as the literature of published research results.

Dr Sophie Domingues is kindly acknowledged for her role and contribution in launching the Research Topic.