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===Elevating head of bed===
*30 degree elevation will help decrease ICP by increasing venous outflow<ref>http://stroke.ahajournals.org/content/38/6/2001.full</ref>

===[[Seizure]] Prophylaxis and Treatment===
*Prophylactic antiepileptics '''not''' recommended<ref>AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage 2015 </ref>
*Continuous EEG monitoring probably indicated in ICH patients with depressed mental status that is out of proportion fo degree of brain injury<ref>AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage 2015 </ref>
*[[Antiepileptics]] indicated for clinical seizures or seizures on EEG in patients with altered mental status<ref>AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage 2015 </ref>

===Blood Pressure===
*Rapid SBP lowering <140 has been advocated with early research showing improved functional outcome<ref>Anderson CS, Heeley E, Huang Y, et al. Rapid blood-pressure lowering in patients with acute intracerebral hemorrhage. N Engl J Med. 2013; 368:2355-2365.</ref>, but more recent work has found no difference between SBP <140 and <180<ref>Qureshi AI, Palesch YY, Barsan WG, et al. Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage. N Engl J Med. 2016; 1-11. [Epub ahead of print].</ref>
*SBP >200 or MAP >150
**Consider aggressive reduction w/ continuous IV infusion
*SBP >180 or MAP >130 and evidence or suspicion of elevated ICP
**Consider reducing BP using intermittent or continuous IV meds to keep CPP >60-80
*SBP >180 or MAP >130 and NO evidence or suspicion of elevated ICP
**Consider modest reduction of BP (e.g. MAP of 110 or target BP of 160/90)


*[[Nicardipine]] in ICH: Start at 5mg/hr, increase 2.5mg q5min until the target blood pressure is achieved and then immediately titrate down to maintenance infusion of 3mg/hr.
*[[Labetalol]] in ICH: 20mg bolus over 1-2 minutes, repeat q3-5 mins until target blood pressure is achieved and then start an infusion of 1-8mg/min.

===Reverse coagulopathy===
[[File:Harobr tICH algorithm.png|thumb|Example ''traumatic'' ICH coagulopathy reversal algorithm.]]
*See [[anticoagulant reversal for life-threatening bleeds]] if on a known anticoagulant (e.g. [[heparin]], [[coumadin]], [[rivaroxaban]])
*[[Tranexamic acid]] 1g (if within 3 hours of event), followed by an additional 1g infused over 8 hours <ref>[[EBQ:CRASH-3 Trial|Crash-3 Trial]]</ref>

====Antiplatelet Reversal====
''Includes [[aspirin]], [[prasugrel]], [[clopidogrel]]''
*Consider [[desmopressin]] (0.3mcg/kg)
*Platelet transfusion
**No known thrombocytopenia: ''increases'' mortality; do '''NOT''' give<ref>[[EBQ:Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomized, open-label, phase 3 trial|(PATCH trial)]]</ref>
**Known or diagnosed thrombocytopenia: consider if platelets <50,000
***Some hematologists and neurosurgeons recommend for <100,000, despite lack of evidence for improved outcomes