Condition

Intracerebral hemorrhage

Clinical trials and treatment information for Intracerebral hemorrhage

16.6M
People Affected
300
Active Trials
664K
New Cases/Year
3.3M
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Rapid Reversal of Anticoagulation
90% Effectiveness• 90% Confidence• 60% Safety• 3 trials• 8K participants
HIGH EvidenceGood ValueDose: PCC (25-50 IU/kg), Vitamin K (5-10 mg IV), Idarucizumab (5g IV), Andexanet Alfa (bolus + infusion)
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Comparative Safety Scale(Higher is safer)

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60
DangerousModerateSafe

Time to Effect

Immediate (minutes to hours)

Duration

Single dose or short course

Response Rate

90%

Remission Rate

%

Number Needed to Treat (NNT)

15

Number Needed to Harm (NNH)

25

Common Side Effects:

Thrombotic events (DVT, PE, MI, stroke): 8%
Allergic reactions: 1%

Annual Cost of Care

Drug Cost

$8,000

Monitoring

$200

Side Effects

$500

Total Annual

$8,700

Cost-Effectiveness

GOOD

QALYs Gained

1

ICER

$60,000/QALY

Cost per Responder

$34,800

Treatment Outcomes
Primary Outcomes
Incidence of Significant Hematoma Expansion (>33% or >6mL within 24h)30% incidence (untreated cohort)
-50% (-15 percentage points)
90-day Mortality40% incidence (untreated cohort)
-20% (-8 percentage points)
Proportion with Good Functional Outcome (mRS 0-3 at 90 days)25% incidence (untreated cohort)
+60% (+15 percentage points)
Median Time to achieve INR < 1.5 (for VKA-related ICH)6 hours (without rapid reversal)
-80% (-4.8 hours)
Secondary Benefits
Length of ICU Stay7 days
-15% (-1.05 days)
Proportion Discharged to Home35% incidence
+20% (+7 percentage points)
Incidence of Post-ICH Seizures10% incidence
-25% (-2.5 percentage points)
Common Side Effects
Thrombotic events (DVT, PE, MI, stroke)
+8%
Allergic reactions
+1%

Clinical Trial Phases:

Phase 3Phase 4
2
External Ventricular Drain (EVD) for Hydrocephalus
88% Effectiveness• 85% Confidence• 50% Safety• 1 trials• 5K participants
MODERATE EvidenceExcellent ValueDose: CSF drainage, specific settings per ICP
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Comparative Safety Scale(Higher is safer)

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Meth💀
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50
DangerousModerateSafe

Time to Effect

Immediate

Duration

Days to weeks

Response Rate

90%

Remission Rate

%

Number Needed to Treat (NNT)

3

Number Needed to Harm (NNH)

15

Common Side Effects:

Ventriculitis/Meningitis: 10%
Hemorrhage (catheter insertion): 3%
Catheter occlusion: 2%

Annual Cost of Care

Drug Cost

$0

Monitoring

$20,000

Side Effects

$2,000

Total Annual

$22,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

1.2

ICER

$20,000/QALY

Cost per Responder

$24,444

Treatment Outcomes
Primary Outcomes
Intracranial Pressure (ICP)25 mmHg
-60% (-15 mmHg)
Ventricular Size (Evans Index)0.35
-20% (-0.07)
Glasgow Coma Scale (GCS) Score8/15
+25% (+2 points)
30-day Mortality Rate40% (expected rate)
-25% (-10% absolute reduction)
Secondary Benefits
Modified Rankin Scale (mRS) Score at 90 days4.5/6 (severe disability)
-33.3% (-1.5 mRS points)
Barthel Index at 90 days30/100 (severe dependence)
+83.3% (+25 points)
Length of ICU Stay14 days
-25% (-3.5 days)
Common Side Effects
Ventriculitis/Meningitis
+10%
Hemorrhage (catheter insertion)
+3%
Catheter occlusion
+2%

Clinical Trial Phases:

Phase 3Phase 4
3
Osmotic Therapy (Mannitol or Hypertonic Saline)
85% Effectiveness• 85% Confidence• 60% Safety• 40 trials• 6K participants
MODERATE EvidenceExcellent ValueDose: Mannitol (0.25-1 g/kg IV), Hypertonic Saline (e.g., 3% NaCl 100-250ml IV bolus)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
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60
DangerousModerateSafe

Time to Effect

Minutes

Duration

Hours to days

Response Rate

80%

Remission Rate

%

Number Needed to Treat (NNT)

4

Number Needed to Harm (NNH)

20

Common Side Effects:

Electrolyte imbalance (e.g., hypernatremia): 15%
Renal dysfunction (with Mannitol): 5%
Hypotension: 3%

Annual Cost of Care

Drug Cost

$500

Monitoring

$200

Side Effects

$100

Total Annual

$800

Cost-Effectiveness

EXCELLENT

QALYs Gained

1

ICER

$10,000/QALY

Cost per Responder

$1,000

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+85%
Response Rate
+80%
Common Side Effects
Electrolyte imbalance (e.g., hypernatremia)
+15%
Renal dysfunction (with Mannitol)
+5%
Hypotension
+3%

Clinical Trial Phases:

Phase 4
4
Intensive Blood Pressure Lowering
80% Effectiveness• 90% Confidence• 70% Safety• 8 trials• 5K participants
HIGH EvidenceExcellent ValueDose: Target SBP < 140 mmHg within 1 hour
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Comparative Safety Scale(Higher is safer)

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70
DangerousModerateSafe

Time to Effect

Immediate (minutes to hours)

Duration

Acute phase (hours to days)

Response Rate

10%

Remission Rate

%

Number Needed to Treat (NNT)

28

Common Side Effects:

Hypotension: 15%
Bradycardia: 2%

Annual Cost of Care

Drug Cost

$3,000

Monitoring

$500

Side Effects

$200

Total Annual

$3,700

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.2

ICER

$35,000/QALY

Cost per Responder

$37,000

Treatment Outcomes
Primary Outcomes
Probability of Hematoma Expansion (>6mL or >33%)28%
-25% (-7 percentage points)
Functional Independence (mRS 0-2) at 90 days38%
+5% (+1.9 percentage points)
Incidence of Early Neurological Deterioration (NIHSS increase >=4)18%
-15% (-2.7 percentage points)
All-cause Mortality at 90 days17%
-3% (-0.5 percentage points)
Secondary Benefits
Intracerebral Hemorrhage Volume at 24 hours22 mL
-10% (-2.2 mL)
Quality of Life (EQ-5D index) at 90 days0.62
+4% (+0.02)
Activities of Daily Living (Barthel Index) at 90 days65/100
+6% (+3.9 points)
Common Side Effects
Hypotension
+15%
Bradycardia
+2%

Clinical Trial Phases:

Phase 3Phase 4
5
Minimally Invasive Surgery (Stereotactic Aspiration/Endoscopic) + rt-PA
65% Effectiveness• 70% Confidence• 30% Safety• 1 trials• 1K participants
MODERATE EvidenceGood ValueDose: rt-PA (0.3mg in 1ml saline, q8h for up to 9 doses)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
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Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
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30
DangerousModerateSafe

Time to Effect

Days (over clot lysis)

Duration

Days (catheter in place)

Response Rate

10%

Remission Rate

%

Number Needed to Treat (NNT)

15

Number Needed to Harm (NNH)

25

Common Side Effects:

Re-hemorrhage: 8%
Infection: 4%
Hydrocephalus: 7%

Annual Cost of Care

Drug Cost

$4,500

Monitoring

$40,000

Side Effects

$5,000

Total Annual

$49,500

Cost-Effectiveness

GOOD

QALYs Gained

0.2

ICER

$56,000/QALY

Cost per Responder

$495,000

Treatment Outcomes
Primary Outcomes
Residual Hematoma Volume (at 72h)45 mL
-66.7% (-30 mL)
Modified Rankin Scale (mRS) Score (at 180 days)4.5 (on 0-6 scale)
-22.2% (-1.0 points)
National Institutes of Health Stroke Scale (NIHSS) Score (at 180 days)18 (on 0-42 scale)
-27.8% (-5 points)
Secondary Benefits
ICH-specific Quality of Life (ICH-QOL, at 180 days)40/100 points
+25% (+10 points)
Length of Intensive Care Unit (ICU) Stay9 days
-22.2% (-2 days)
Ventilator-free Days (within 28 days)18 days (out of 28)
+22.2% (+4 days)
Common Side Effects
Re-hemorrhage
+8%
Infection
+4%
Hydrocephalus
+7%

Clinical Trial Phases:

Phase 3
6
Open Craniotomy for Hematoma Evacuation
55% Effectiveness• 60% Confidence• 25% Safety• 5 trials• 3K participants
MODERATE EvidencePoor ValueDose: Surgical procedure (depending on clot size and location)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
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25
DangerousModerateSafe

Time to Effect

Immediate post-op

Duration

Acute intervention, then rehabilitation

Response Rate

5%

Remission Rate

%

Number Needed to Treat (NNT)

20

Number Needed to Harm (NNH)

10

Common Side Effects:

Infection: 8%
Neurological deficit worsening: 15%
Seizure: 10%
Hydrocephalus: 7%

Annual Cost of Care

Drug Cost

$0

Monitoring

$100,000

Side Effects

$15,000

Total Annual

$115,000

Cost-Effectiveness

POOR

QALYs Gained

0.3

ICER

$180,000/QALY

Cost per Responder

$2,300,000

Treatment Outcomes
Primary Outcomes
Intracerebral Hematoma Volume45 cm³
-70% (-31.5 cm³)
Intracranial Pressure (ICP)25 mmHg
-60% (-15 mmHg)
NIHSS Score18/42
-25% (-4.5 points)
Modified Rankin Scale (mRS) Score at 90 days4/6
-25% (-1 point)
Secondary Benefits
Glasgow Coma Scale (GCS) Score10/15
+20% (+2 points)
Barthel Index at 90 days40/100
+37.5% (+15 points)
Ventilator-free days at 28 days10 days
+50% (+5 days)
Common Side Effects
Infection
+8%
Neurological deficit worsening
+15%
Seizure
+10%

Clinical Trial Phases:

Phase 3Phase 4