Intracerebral haemorrhage

Abstract

Although less common than ischaemic stroke, intracerebral haemorrhage (ICH) accounts for a similar global burden of morbidity and mortality. Precision medicine aims to improve clinical outcomes by accounting for individual variation; however, its implementation in ICH, a disease without proven disease-modifying treatments, may appear challenging. Despite this, aided by an increasing range of neuroimaging biomarkers for the vasculopathies causing ICH, opportunities for precision medicine in ICH are emerging, notably in aetiological diagnosis, selection of secondary prevention strategies, and development of clinical prediction models for recurrence and functional outcome. Advances in the mechanistic understanding of ICH also offer the opportunity for clinical trials targeting specific aspects of pathophysiology in selected patient groups, an approach which may offer new hope for neuroprotective acute treatments. Here, we review these emerging areas, and the prospects for precision medicine in ICH in the near future.