Brain Damage Newsroom

New Drug Slows Bleeding and Limits Brain Damage

The first proven treatments for often-fatal intracerebral hemorrhage (bleeding strokes) are on the horizon, including a new drug called recombinant activated factor VII (rFVIIa) that slows bleeding and limits brain damage, according to updated guidelines released Thursday by the American Heart Association (AHA). The drug is currently approved in the United States to treat hemophilia patients. The new AHA guidelines suggest that using the drug on intracerebral hemorrhage (ICH) patients within four hours of ICH onset may limit the amount of bleeding, reduce the risk of death, and improve survivors' functional outcome at 90 days. "rFVIIa is mentioned as potential new treatment that needs confirmation.

The efficacy and safety of this treatment must be established in an ongoing phase III trial before its use in patients," Dr. Joseph Broderick, chairman of the guideline writing committee and professor and chairman in the neurology department at the University of Cincinnati, said in a prepared statement. ICH occurs when a defective artery in the brain bursts and floods the surrounding tissue with blood. Of the more than 60,000 people who have an ICH each year in the United States, 35 percent to 52 percent die within a month and only 20 percent are expected to be functionally independent six months after the ICH.The best way to prevent ICH is to avoid high blood pressure, Broderick said.

The updated guidelines, published in the current issue of Stroke, also address the feasibility and timing of surgery to treat ICH patients. "We don't recommend routine surgical treatment of ICH, but people who have larger blood clots close to the surface of the brain may be an exception," Broderick said. The guidelines do recommend surgery for patients with a larger ICH in the cerebellum that presses on the brain stem. Broderick and his colleagues also made recommendations about the use of medical imaging technology to diagnose ICH and end-of-life issues for ICH patients.