Integrated ICH Care Pathway Across Stroke Service Levels: Time for a New Model of Care

Intracerebral hemorrhage (ICH) is one of the leading causes of death and disability worldwide, and the limited number of proven treatments is a critical area of medical concern. Although tremendous advances have been made in our knowledge of the patterns, risk factors, prognosis, management, and prevention, there has been limited success in defining therapeutic strategies and care remains fragmented and haphazard. The establishment of targeted, timely, and comprehensive management for patients with ICH is an urgent and critical priority. This consensus statement proposes an integrated ICH care pathway across stroke service levels, embedding ICH-specific protocols, time targets, and structured follow-up within existing stroke systems to ensure timely, evidence-based, and comprehensive management. The integrated ICH care pathway is designed to optimize ICH management across multiple dimensions, facilitate rapid decision-making and the initiation of treatments that span emergency medical services, emergency departments, and inpatient units, and extend through discharge and follow-up. The primary objective is to reduce delays and reinforce seamless collaboration between services to ensure all patients receive optimal care. By integrating evidence-based protocols for acute management, secondary prevention, rehabilitation, and follow-up, the integrated ICH care pathway aims to improve outcomes from ICH and foster a standardized multidisciplinary care framework with the goal of alleviating the clinical burden and socioeconomic impact of ICH.