Bleeding Intracerebral Hemorrhage With Early Invasive Intracranial Pressure Monitoring Trial

Prior treatment

• Participants not receiving the invasive intracranial pressure (ICP) monitoring module according to their assigned group.

Other illness

• Traumatic cerebral hemorrhage, cerebral amyloid angiopathy(CAA), secondary cerebral hemorrhage due to other specific etiologies (aneurysm, vascular malformation, smoker's disease, coagulopathy, aneurysmal stroke, vasculitis, cerebral venous thrombosis, hemorrhagic cerebral infarction, etc.)
• Individuals unable to complete the follow-up phase of this trial due to psychiatric, cognitive, or emotional conditions;
• Acute onset of other life-threatening illnesses identified as the primary cause of mortality;

Lab values

• The presence of other serious underlying diseases (intractable hypoxemia and circulatory failure with cardiopulmonary insufficiency that is difficult to correct by treatment, severe abnormal coagulation, severely reduced platelets, severe hepatic and renal insufficiency, combined neurodegenerative diseases, psychiatric diseases, autoimmune diseases, malignant tumors, thyroid diseases, etc.)

Other

• The presence of fixed bilateral dilated pupils on admission, no recovery of pupils after initial dehydration treatment, and very poor survival
• Patients with extremely unstable vital signs after admission, with extremely poor prognosis and those considered non-viable, and patients whose families have abandoned follow-up treatment
• Patients who are pregnant or lactating.
• Patients with bilateral temporal skin ulceration, or subcutaneous hematoma in which monitoring electrode placement cannot be implemented
• The patient is agitated, coughing or choking too frequently, unable to be sedated or has difficulty in handling.
• Those with mRS score \> 2 before this onset.
• Family members decline to provide informed consent.
  • Exit criteria:
• Participants who voluntarily withdraw from the study before completion;
• Participants deemed unsuitable for the trial's monitoring protocol post-enrollment;
• Participants requiring a modification of the treatment plan post-enrollment due to medical reasons, resulting in compromised monitoring feasibility or significant deviations in monitoring accuracy that undermine the integrity of the final analysis.
  • Elimination criteria：
• Participants who failed to record any data post-enrollment;
• Participants who did not receive per-protocol treatment post-enrollment, were discharged within 72 hours, and had their families voluntarily withdraw informed consent;
• Participants whose invasive intracranial pressure (ICP) monitoring probes shifted and were not promptly reinserted or calibrated, leading to excessive data errors precluding analysis;

• Age ≥18 years old and Age \<80 years old.
• Diagnosed of a supratentorial spontaneous intracerebral hemorrhage.
• Diagnosis of supratentorial large-volume cerebral hemorrhage by CT or other imaging and meeting the diagnostic criteria for large-volume cerebral hemorrhage(hemorrhage volume ≥ 30 mL of supratentorial cerebral parenchymal hematoma volume according to the Coniglobus formula on the first CT scan at onset).
• Participants were enrolled within 48 hours of symptom onset.
• The family signed the informed consent.