Early control of elevated blood pressure is the most promising treatment for acute intracerebral hemorrhage. We aimed to establish whether implementing a goal-directed care bundle incorporating protocols for early intensive blood pressure lowering and management algorithms for hyperglycemia, pyrexia, and abnormal anticoagulation, implemented in a hospital setting, could improve outcomes for patients with acute spontaneous intracerebral hemorrhage.

Implementation of a care bundle protocol for intensive blood pressure lowering and other management algorithms for physiological control within several hours of the onset of symptoms resulted in improved functional outcome for patients with acute intracerebral hemorrhage. Hospitals should incorporate this approach into clinical practice as part of active management for this serious condition.

The findings of this trial provide evidence to support the adoption of an active protocol for intensive blood pressure lowering and the associated management of key abnormal physiological variables within several hours after the onset of signs to improve the recovery of patients presenting with acute intracerebral hemorrhage.

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