Optimization of the Management of Non-Traumatic Intracerebral Hemorrhage (OPT-ICH)

The project consists of 2 parts:

• Retrospective, multicentric, observational study. Inclusion of all patients presenting with ICH admitted urgently to the University Hospital of Tours between 2018-2021.
• Prospective, multicentric, observational study. Inclusion of all patients presenting with ICH admitted urgently to the University Hospital of Tours, Angers and Poitiers.

Each patient will benefit from management according to a protocol which will include:

• Emergency MRI with contrast injection (contrast-enhanced brain CT scan if contraindicated);
• Admission to the Neurovascular Unit unless hemodynamically unstable or intubated;
• First intravenous antihypertensive injection with a goal < 1 hour from arrival at the hospital;
• Anticoagulation reversal with a goal < 1 hour from arrival at the hospital;
• Standard laboratory tests + coagulation study ;
• Neurosurgical consultation upon arrival at the department;
• Follow-up MRI at 24-48 hours or earlier if clinical worsening;
• Diagnostic work-up for the evaluation of hypertension-related end organ damage (Transthoracic echocardiogram, retinography , proteinuria);
• Contrast-enhanced follow-up MRI at 3-6 months;
• Neurological evaluation at 6 months and 2 years;
• When applicable a neuropsychological evaluation at 6M and 2 Y;

Inclusion criteria

• aged over 18 years
• emergency admission to the University Hospital of Tours
• having an ICH on imaging performed upon admission (CT scan or MRI) at the University Hospital of Tours

Exclusion criteria

• Patient who has given their opposition to the collection of their data