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Intracerebral hemorrhage (ICH) remains the most lethal stroke subtype.1 As many as 40% of acute ICH expand within the first 4 hours from symptom onset.2,3⇓ Such hemostatic complications hamper surgical efforts to extract the hematoma.4 Some suggest that arterial hypertension may be responsible for rebleeding despite the lack of evidence from observational studies.5 Moreover, treating arterial hypertension might in theory reduce cerebral edema related to ICH. Blood pressure lowering in acute ischemic stroke worsens cerebral ischemia.6 The area surrounding an intracerebral hemorrhage may behave in a similar fashion.7 Disturbances in cerebral autoregulation and local tissue effects may make the perihematoma area vulnerable to damage with acute blood pressure lowering. However, perihematomal ischemia is generally not seen in animal models …
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