ABSTRACT
Recombinant factor VIIa may be the first proven treatment for intracerebral hemorrhage (ICH); to be effective, it must be given soon after the onset of symptoms. Surgical removal of the hematoma by craniotomy at about 24 hours does not appear to offer much benefit compared with conservative therapy and delayed surgery, except possibly for superficial ICHs. Standardized management of medical complications remains important. New randomized treatment trials of recombinant factor VII and surgery are in progress or just beginning.
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