Aidoc Staff

Can AI Help Elevate and Standardize ICH Protocols?

Protocols save lives, especially in neuro care. In the face of workforce shortages and an ever increasing influx of patients in health systems, the necessity of standardized protocols and procedures to address patients with brain injuries is more important than ever. Yet as it stands, not all pathologies are created equal. 

An international panel of clinical researchers recently published a report in the Stroke journal, calling out the need for an “immediate change” to the protocols, or lack thereof, for intracranial hemorrhage (ICH) patients. As it stands, ICH protocols vary widely across institutions, with diagnoses coming from inconsistent imaging utilization, no clear time metrics and unclear guidance regarding hematologic therapy and surgical intervention. What the authors suggest is a widespread effort to elevate the care standard of ICH to be closer to that of ischemic stroke, where patients greatly benefit from the downstream effects of meticulously thought out (and highly adopted) treatment protocols. This would mean that ICH patients receive a combination of “early intervention, bundled care, and time-based metrics” in the effort to improve neurological outcomes. 

In a domain where “time is brain,” artificial intelligence (AI) is poised to play a notable role in elevating this standard of care and empower physicians to match the effective measures already in place for ischemic stroke patients.


Intracranial hemorrhage is associated with high morbidity and mortality, with early term mortality as high as 40%. Over 70% of ICH’s have been shown to expand in the first 24 hours from the onset due to continued or repeat bleeding. Furthermore, a study by Brott et al. revealed that 26% of ICH patients had hematoma expansion within 1 hour of the first CT scan.

By flagging suspected positive ICH findings on a brain scan, clinical AI can help triage suspected ICH findings for radiologists. By elevating the right patient at the right time to the right physician(s), AI can enable care teams to act fast on patients in need.

AI-Powered Care Coordination

If such protocols were to be widely adopted for ICH patients, AI-powered care coordination tools would serve as the natural conduit to enact this change. By acting as a triage tool, AI can notify designated specialists with patient records and images, enabling them to detect ICH cases and push these patients to care coordination teams. In a recent publication by Petry et al., “the introduction of computer-aided triage and prioritization appears to have coincided with a significant decrease in length of stay for patients diagnosed with ICH.” Whether a patient needs reversal blood thinners or surgical intervention, hospitals who adopt AI for ICH triage may be able to treat their patients faster and reduce the overall average length of stay. 

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Aidoc Staff