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Intensive lowering of systolic blood pressure to &lt;140\u2005mm\u2005Hg is proven safe by two recent randomised trials. Transfusion of platelets in patients on antiplatelet therapy is not indicated unless the patient is scheduled for surgical evacuation of haematoma. In patients with small haematoma without significant mass effect, there is no indication for routine use of mannitol or hypertonic saline (HTS). However, for patients with large ICH (volume &gt; 30\u2005cbic centmetre) or symptomatic perihaematoma oedema, it may be beneficial to keep serum sodium level at 140\u2013150\u2005mEq\/L for 7\u201310\u2005days to minimise oedema expansion and mass effect. Mannitol and HTS can be used emergently for worsening cerebral oedema, elevated intracranial pressure (ICP) or pending herniation. HTS should be administered via central line as continuous infusion (3%) or bolus (23.4%). Ventriculostomy is indicated for patients with severe intraventricular haemorrhage, hydrocephalus or elevated ICP. Patients with large cerebellar or temporal ICH may benefit from emergent haematoma evacuation. It is important to start intermittent pneumatic compression devices at the time of admission and subcutaneous unfractionated heparin in stable patients within 48\u2005hours of admission for prophylaxis of venous thromboembolism. There is no benefit for seizure prophylaxis or aggressive management of fever or hyperglycaemia. Early aggressive comprehensive care may improve survival and functional recovery.<\/jats:p>","DOI":"10.1136\/svn-2016-000047","type":"journal-article","created":{"date-parts":[[2017,1,24]],"date-time":"2017-01-24T21:12:14Z","timestamp":1485292334000},"page":"21-29","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":138,"title":["Current management of spontaneous intracerebral haemorrhage"],"prefix":"10.1136","volume":"2","author":[{"given":"Cyrus K","family":"Dastur","sequence":"first","affiliation":[{"name":"Department of Neurology, University of California Irvine, Irvine, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wengui","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of California Irvine, Irvine, California, 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