ESOC 2022 | Key questions in hemorrhagic stroke: role of blood pressure control and surgical therapy

Thorsten Steiner, MD, PhD, Frankfurt Höchst Clinic, Frankfurt & Heidelberg University, Heidelberg, Germany, highlights key talking points in the field of hemorrhagic stroke. One such topic is the role of blood pressure control in the prevention of hematoma expansion. Hematoma volume is the greatest predictor of morbidity and mortality after intracerebral hemorrhage. Several studies have shown that intensive blood pressure reduction is associated with a decreased risk of hematoma expansion, but it is not yet clear if this translates to clinical benefits. Recent randomized clinical trials found that the reduction in hematoma growth only correspond to minimal or no benefit on clinical outcomes. Surgical therapies is another focus in hemorrhagic stroke. The use of varying methods, time windows, patient characteristics, and stroke characteristics across studies has led to a lack of valuable conclusions. Trials are needed that study the impact of surgery in specific locations of the brain and compare specific surgical approaches. This interview took place at European Stroke Organisation Conference 2022 in Lyon, France.