Key Terms: ICH, blood pressure control, spot sign Hosts: Phavalan Rajendram, Neha Patel, Houman Khosravani Summary: Hemorrhagic strokes (HS) account for ~15-20% of all strokes There is a significant morbidity and mortality associated with HS Early blood pressure control is key in the management of HS CTA can identify a spot sign (may indicate increased risk of hematoma expansion) Etiologies Find out if the patient is on anticoagulation so that it can be reversed Make sure the patient is stable before CT scan (may need anti-emetics, intubation, etc.) Early blood pressure control is key Blood pressure target 140/90 See ATACH-2 and INTERACT trials on BP control in ICH Consult NSx early as surgical options may be available See STICH-2 trial on surgical management of superficial ICH without IVH Prognostication can be aided with “ICH Score”