Intracerebral haemorrhage (ICH) is a devastating condition associated with high mortality and substantial residual disability among survivors. Effective treatments for the acute stages of ICH are limited. However, promising findings from randomized trials of therapeutic strategies, including acute care bundles that target anticoagulation therapies, blood pressure control and other physiological parameters, and trials of minimally invasive neurosurgical procedures have led to renewed optimism that patient outcomes can be improved. Currently ongoing areas of research for acute treatment include anti-inflammatory and haemostatic treatments. The implementation of effective secondary prevention strategies requires an understanding of the aetiology of ICH, which involves vascular and brain parenchymal imaging; the use of neuroimaging markers of cerebral small vessel disease improves classification with prognostic relevance. Other data underline the importance of preventing not only recurrent ICH but also ischaemic stroke and cardiovascular events in survivors of ICH. Ongoing and planned randomized controlled trials will assess the efficacy of prevention strategies, including antiplatelet agents, oral anticoagulants or left atrial appendage occlusion (in patients with concomitant atrial fibrillation), and optimal management of long-term blood pressure and statin use. Together, these advances herald a new era of improved understanding and effective interventions to reduce the burden of ICH.

脑出血 （ICH） 是一种与幸存者的高死亡率和大量残留残疾相关的破坏性疾病。ICH 急性期的有效治疗有限。然而，治疗策略的随机试验（包括针对抗凝疗法、血压控制和其他生理参数的急性护理集束化）以及微创神经外科手术的试验，令人鼓舞的发现使人们对患者预后可以得到改善的新乐观情绪重新燃起。目前正在进行的急性治疗研究领域包括抗炎和止血治疗。实施有效的二级预防策略需要了解 ICH 的病因，包括血管和脑实质成像;脑小血管病神经影像学标志物的使用改善了具有预后相关性的分类。其他数据强调了预防 ICH 幸存者复发性 ICH 以及缺血性卒中和心血管事件的重要性。正在进行和计划的随机对照试验将评估预防策略的有效性，包括抗血小板药物、口服抗凝剂或左心耳封堵（在伴有心房颤动的患者中），以及长期血压和他汀类药物使用的最佳管理。总之，这些进步预示着一个新时代，即提高理解和有效干预以减轻 ICH 的负担。