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(Stroke. 2007;38:204.)
© 2007 American Heart Association, Inc.

Cochrane Corner

Hemostatic Drug Therapies for Acute, Nontraumatic Intracerebral Hemorrhage

From the Division of Clinical Neurosciences, Centre for Clinical Brain Sciences, School of Molecular and Clinical Medicine, University of Edinburgh, UK.

Correspondence to Dr Rustam Al-Shahi, MA PhD MRCP(UK), MRC clinician scientist, Bramwell Dott Building, Division of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh EH4 2XU, UK. E-mail Rustam.Al-Shahi@ed.ac.uk

Section Editor: Graeme J. Hankey MD, FRCP

Key Words: acute cerebral hemorrhage • intracerebral hemorrhage • emergency treatment of stroke • other stroke treatment, medical

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Because nontraumatic intracerebral hemorrhage (ICH) volume strongly influences its outcome and a third of ICHs enlarge by a third within 24 hours of onset, hemostatic drug therapy given very soon after ICH onset might improve outcome.

	Objective

 
We sought to determine the clinical effectiveness and safety of hemostatic drug therapies for acute nontraumatic ICH in randomized controlled trials (RCTs).

	Search Strategy

 
In August 2005 we searched the Cochrane Stroke Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE from 1966 and EMBASE from 1980. We also scanned bibliographies of relevant articles, searched international registers of clinical trials and research, and contacted authors and pharmaceutical companies.

	Selection Criteria

 
We sought randomized controlled trials of any hemostatic drug therapy for acute nontraumatic ICH, compared against placebo or open control, with relevant clinical outcome measures.

	Data Collection and Analysis

 
Two review authors (R.A.-S., H.Y.) independently applied the inclusion criteria, reviewed the relevant studies, and extracted data from them.

	Main Results

 
We found 4 phase II RCTs, involving adults aged 18 years or over, within 4 hours of nontraumatic ICH. One hundred and sixteen study participants received placebo and 373 received hemostatic drugs (2 received -aminocaproic acid and 371 received recombinant activated factor VII [rFVIIa]).

Hemostatic drugs reduced the relative risk of death within 90 days of nontraumatic ICH (risk reduction [RR] 0.67; 95% CI, 0.46 to 0.97, random effects; Figure). Specifically, rFVIIa appeared to reduce the risk of death or dependence on the modified Rankin Scale (grades 4 to 6) within 90 days of nontraumatic ICH (RR 0.79; 95% CI, 0.67 . . . [Full Text of this Article]