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Jul 8, 2025, 17:38

ESO–EANS Rewrites the Rulebook on Spontaneous ICH: First Update Since 2014

The European Stroke Organization (ESO) has recently shared an insightful post on X:

”The new ESO–EANS guideline on intracerebral haemorrhage outlines best practice for acute care, surgery, and blood pressure control.”

To access the guideline, read the full article here.

Thorsten Steiner et al. shade light on the management of intracerebral haemorrhage in a newly published ”European Stroke Organisation (ESO) and European Association of Neurosurgical Societies (EANS) guideline on stroke due to spontaneous intracerebral haemorrhage” in the SAGE Journals.

The European Stroke Organisation (ESO) and European Association of Neurosurgical Societies (EANS) have updated their guidelines on spontaneous ICH for the first time since 2014.

Despite reviewing over 115,000 articles and including 208 studies, only a handful of strong recommendations emerged.

These include treating ICH patients in organised stroke units and lowering blood pressure to prevent recurrence.

Strong evidence supports stroke unit care and blood pressure control for secondary prevention, while weak evidence backs prediction scores for macrovascular causes of ICH.
Strong evidence discourages anti-inflammatory use outside trials, while weak evidence cautions against routine use of rFVIIa, platelet transfusions, early treatment restrictions, and isolated temperature or glucose control.

These and more findings highlight the ongoing need for high-quality trials embedded in clinical care.

ESO–EANS Rewrites the Rulebook on Spontaneous ICH: First Update Since 2014