Medical management of increased intracranial pressure after spontaneous intracerebral hemorrhage.

There are several medical therapies available to lower unacceptable ICP. We advocate the stepwise institution of these therapies to maintain adequate CPP. At every step in the process, consideration of definitive surgical intervention (e.g., hemicraniectomy, clot evacuation) should be entertained. At this time, we cannot recommend hypothermia as a routine last step of therapy given the complications and lack of clinical effect described previously. Research into this therapy continues, however. The next several years may show us when, how, and in what situations this strategy can be applied.