The first proven treatments for often fatal intracerebral hemorrhage (bleeding strokes) are on the horizon, including a new drug called recombinant activated factor VII (FVIIa) that slows bleeding and limits brain damage, according to updated guidelines from the American Heart Association (AHA). The new drug is approved in the US to treat hemophilia patients.

New Guidelines

The new AHA guidelines suggest that using the drug on intracerebral hemorrhage (ICH) patients within four hours of ICH onset may limit the amount of bleeding, reduce the risk of death, and improve survivors' functional outcome at 90 days.

ICH occurs when an artery in the brain bursts and floods the surrounding tissue with blood. Of the more than 60,000 people who have an ICH each year in the US, 35% to 52% die within a month and only 20% are expected to be functionally independent six months after the ICH.

The best way to prevent ICH is to avoid high blood pressure.

"We don't recommend routine surgical treatment of ICH, but people who have larger blood clots close to the surface of the brain may be an exception," said Dr. Joseph Broderick, chairman of the guideline writing committee and professor and chairman in the neurology department at the University of Cincinnati.

The guidelines do recommend surgery for patients with a larger ICH in the cerebellum that presses on the brain stem.

Broderick and colleagues also made recommendations about the use of medical imaging technology to diagnose ICH.

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