Grant: Project Grant

Acute spontaneous intracerebral hemorrhage (ICH) is the most devastating and least treatable type of stroke, which accounts for ~20% of the near 20 million new cases of stroke that occur in the world each year. Approximately 40% of these patients die within one month of onset of ICH, and most survivors are left with some form of disability. While new therapies for ischemic stroke have transformed systems of care, the situation is far different for patients with ICH, where the absence of any proven treatment has led to physicians believing they cannot treat this disease. No standardised systems of care have been adopted for ICH. I-CATCHER aims to determine the effectiveness of implementing a Care Bundle involving early physiological control of some of the physical effects of ICH, like hypertension and hyperglycaemia, reversing drugs that may worsen ICH, like anticoagulants, address avoidance of do-not-resuscitate (DNR) orders for 48 hours, and provide a referral pathway for neurosurgery. This study utilizes a modern, pragmatic design that will enable the trial to provide early feedback on whether these changes are effective.