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Guidelines
Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of intracerebral haemorrhage
  1. Yong Cao1,2,
  2. Songlin Yu1,2,
  3. Qian Zhang1,2,
  4. Tao Yu1,2,
  5. Yanfang Liu3,
  6. Zhenghui Sun4,
  7. Meng Zhao1,2,
  8. Wen Wang1,2,
  9. Ji Zong Zhao1,2
  10. Chinese Stroke Association Stroke Council Guideline
    1. 1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
    2. 2 China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China
    3. 3 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
    4. 4 Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
    1. Correspondence to Professor Ji Zong Zhao; zhaojz205{at}163.com

    Abstract

    Aim This evidence-based guideline aims to present current and comprehensive recommendations for the diagnosis and management of spontaneous intracerebral haemorrhage (ICH).

    Methods A formal literature search was conducted on MEDLINE (1 January 1990 to 30 June 2019). Data were synthesised using evidence tables. The members of the working group met by teleconference to update and formulate data-based recommendations. The recommendations are graded according to levels of evidence grading algorithm of the Chinese Stroke Association. The guideline draft has been reviewed by Chinese Stroke Association Stroke Council Guideline Writing Committee.

    Results Evidence-based guideline is proposed for the management of patients with ICH. The focus of the guideline is divided into the diagnosis and aetiology of ICH, management of ICH in emergency department, surgical treatment for removal of hematoma, management of complications and prevention of secondary ICH.

    Conclusions This guideline provides a framework for ICH management. Early active and reasonable treatment may improve the clinical outcome of patients.

    • brain
    • hemorrhage
    • stroke
    http://creativecommons.org/licenses/by-nc/4.0/

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

    https://doi.org/10.1136/svn-2020-000433

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      Footnotes

      • YC and SY contributed equally.

      • Collaborators Chinese Stroke Association Stroke Council Guideline: Writing Committee Chairmen: Yongjun Wang (yongjunwang@ncrcnd.org.cn, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China). Jizong Zhao (zhaojz205@163.com/zhaojz@public.bta.net.cn, Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China). Vice-Chairmen: Qiang Dong (dong_qiang@fudan.edu.cn, Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China). Anding Xu (tlil@jnu.edu.cn, Department of Neurology and Stroke Center, the First Affiliated Hospital, Jinan University, Guangzhou, China). Members of Academic Committee: Kangning Chen (ckn_640827@126.com, Department of Neurology, The Southwest Hospital, the First Affiliated Hospital of Third Military Medical University, Chongqing, China). Junbo Ge (ge.junbo@zs-hospital.sh.cn, Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China). Li Guo (guoli6@163.com, Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China). Li He (heli2003new@126.com, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China). Bo Hu (hubo@hust.edu.cn, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China). Yong Huo (huoyong@263.net.cn, Department of Cardiology, Peking University First Hospital, Beijing, China). Linong Ji (jiln@bjmu.edu.cn, Department of Endocrinology and Metabolism, Peking University People’s Hospital, Medicine at Peking University, Beijing, China). Xunming Ji (robertjixm@hotmail.com/jixunming@vip.163.com, Department of Neurosurgery, Xuanwu Hospital, Capital University of Medicine, Beijing, China), Tielin Li (tielin2013@126.com/tielin.li@tom.com, Zhujiang Hospital of Southern Medical University, Guangzhou, China). Liping Liu (lipingsister@gmail.com, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China). Benyan Luo (luobenyan@zju.edu.cn, Department of Neurology, 1st Affiliated Hospital of Zhejiang University, Hangzhou, China). Zhongrong Miao (zhongrongm@163.com, Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China). Xiaoyuan Niu (niuxiaoyuan1958@163.com, Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China). Bin Peng (pengbin3@hotmail.com, Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China). Dingfeng Su (dfsu@smmu.edu.cn, Department of Pharmacology, the Second Military Medical University (SMMU), Shanghai, China). Beisha Tang (bstang7398@163.com, Department of Neurology, Xiangya Hospital, Central South University, Changsha, China). Chen Wang (wangchen-tr2002@163.com, Beijing Tiantan Hospital, Capital Medical University, Beijing, China). Ning Wang (nwang900@yahoo.com, Department of Neurology and Institute of Neurology, First Affiliated Hospital of Fujian Medical University, Fuzhou, China). Shuo Wang (captain9858@vip.sina.com, Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China). Wei Wang (wwang@vip.126.com/wwang@tjh.tjmu.edu.cn, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China). Xin Wang (wang.xin@zs-hospital.sh.cn, Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China). Yilong Wang (yilong528@aliyun.com, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China). Shizheng Wu (wushizheng2005@hotmail.com, Qinghai Province People’s Hospital, Xining, China). Peng Xie (xiepeng@cqmu.edu.cn, Chongqing Medical University (CQMU), Chongqing, China). Yuming Xu (13903711125@126.com/xym13903711125@126.com, Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China). Yun Xu (xuyun20042001@aliyun.com, Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China). Yi Yang (doctoryangyi@163.com/doctor_yangyi@hotmail.com, Department of Neurology, the First Hospital of Jilin University, Changchun, China). Jinsheng Zeng (zengjs@pub.guangzhou.gd.cn, Department of Neurology and Stroke Center, the First Affiliated Hospital of Sun Yat-Sen University, Guangdong, China). Chaodong Zhang (scdzhang@163.com, The First affiliated Hospital of China Medical University, Shenyang, China). Tong Zhang (zt61611@sohu.com, Capital Medical University School of Rehabilitation Medicine, China Rehabilitation Research Center, Beijing, China). Zhuo Zhang (zzhuo005@gmail.com, Beijing Anzhen Hospital, Capital Medical University, Beijing, China). Gang Zhao (zhaogang@fmmu.edu.cn, Department of Neurology, Xijing Hospital, The 4th Military Medical University, Xi’an, China). Xingquan Zhao (zxq@vip.163.com, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China).

      • Contributors JZZ designed the framework and protocol and participated in revision. YC drafted the sections of diagnosis and evaluation of causes of ICH. SY and YL drafted the section of emergency department management of ICH. QZ and TY drafted the section of surgical treatment for removal of hematoma. ZS and MZ drafted the section of complications management of ICH. WW drafted the section of recurrence and prevention of secondary ICH. YC and SY reviewed the design and interpretation of all studies, confirmed the level of evidence and classification and revised the manuscript.

      • Funding This research received specific funding from Chinese Stroke Association Stroke Council Guideline Writing Committee.

      • Competing interests None declared.

      • Patient consent for publication Not required.

      • Provenance and peer review Commissioned; externally peer reviewed.