Aggressive blood-pressure lowering in patients presenting in ED with a primary deep intracerebral haemorrhage curbs haematoma expansion in the following 24 hours, a post-hoc trial analysis shows.

The results come from assessments of CT imaging scans for 780 patients included in the ATACH-2 study who had bleeds in the basal ganglia or the thalamus, deep in the brain, and presented within 4.5 hours of stroke.

Approximately half were randomly allocated to aggressive lowering of systolic BP using intravenous nicardipine to 110-139mmHg, while the remainder received usual care with a systolic BP target of 140-179mmHg.

Using scans taken at admission and 24 hours later, the researchers found those who had aggressive BP-lowering had a smaller expansion of their haematoma, reported the authors led by neurointerventionist Dr Guido Falcone, from Yale School of Medicine.