30 degree elevation will help decrease ICP by increasing venous outflow
Prophylactic antiepileptics not recommended
Continuous EEG monitoring probably indicated in ICH patients with depressed mental status that is out of proportion fo degree of brain injury
Antiepileptics indicated for clinical seizures or seizures on EEG in patients with altered mental status
Rapid SBP lowering <140 has been advocated with early research showing improved functional outcome, but more recent work has found no difference between SBP <140 and <180
SBP >200 or MAP >150
Consider aggressive reduction w/ continuous IV infusion
SBP >180 or MAP >130 and evidence or suspicion of elevated ICP
Consider reducing BP using intermittent or continuous IV meds to keep CPP >60-80
SBP >180 or MAP >130 and NO evidence or suspicion of elevated ICP
Consider modest reduction of BP (e.g. MAP of 110 or target BP of 160/90)
Consider aggressive reduction w/ continuous IV infusion
Consider reducing BP using intermittent or continuous IV meds to keep CPP >60-80
Consider modest reduction of BP (e.g. MAP of 110 or target BP of 160/90)

Nicardipine in ICH: Start at 5mg/hr, increase 2.5mg q5min until the target blood pressure is achieved and then immediately titrate down to maintenance infusion of 3mg/hr.
Labetalol in ICH: 20mg bolus over 1-2 minutes, repeat q3-5 mins until target blood pressure is achieved and then start an infusion of 1-8mg/min.
See anticoagulant reversal for life-threatening bleeds if on a known anticoagulant (e.g. heparin, coumadin, rivaroxaban)
Tranexamic acid 1g (if within 3 hours of event), followed by an additional 1g infused over 8 hours 
Includes aspirin, prasugrel, clopidogrel
Consider desmopressin (0.3mcg/kg)
Platelet transfusion
No known thrombocytopenia: increases mortality; do NOT give
Known or diagnosed thrombocytopenia: consider if platelets <50,000
Some hematologists and neurosurgeons recommend for <100,000, despite lack of evidence for improved outcomes
No known thrombocytopenia: increases mortality; do NOT give
Known or diagnosed thrombocytopenia: consider if platelets <50,000
Some hematologists and neurosurgeons recommend for <100,000, despite lack of evidence for improved outcomes
Some hematologists and neurosurgeons recommend for <100,000, despite lack of evidence for improved outcomes
Consider neuroprotective intubation
3 minutes before intubation
Lidocaine 1-2mg/kg to blunt sharp MAP increase
Fentanyl 2-5mcg/kg as sympatholytic
Sedation
Etomidate if blood pressure normal
Propofol if blood pressure high
Succinylcholine without defasciculating dose
Ensure patient is pain-free for post-intubation sedation
Propofol with fentanyl
Try to prioritize pain control with fentanyl
3 minutes before intubation
Lidocaine 1-2mg/kg to blunt sharp MAP increase
Fentanyl 2-5mcg/kg as sympatholytic
Sedation
Etomidate if blood pressure normal
Propofol if blood pressure high
Succinylcholine without defasciculating dose
Lidocaine 1-2mg/kg to blunt sharp MAP increase
Fentanyl 2-5mcg/kg as sympatholytic
Etomidate if blood pressure normal
Propofol if blood pressure high
Propofol with fentanyl
Try to prioritize pain control with fentanyl
Hemorrhagic stroke
Intra-axial
Ischemic stroke
Hemorrhagic stroke 
Subarachnoid hemorrhage
Traumatic intracerebral hemorrhage
Stroke 
Extra-axial