Emerging approaches in the management of intracranial hemorrhage: ARISE II consensus recommendations
Authors
Mark Bain, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA bainm@ccf.org.
Christopher Paul Kellner, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Ricardo A. Hanel, Neurosurgery, Baptist Medical Center Jacksonville, Jacksonville, Florida, USA.
Jan-Karl Burkhardt, Department of Neurosurgery, NYU Langone Health, New York, NY, USA.
David Fiorella, Department of Neurosurgery, Stony Brook University, Stony Brook, New York, USA.
Juhana Frosen, Neurosurgery, Tampere University Hospital, Tampere, Pirkanmaa, Finland.
Brian Jankowitz, Neurosurgery, University of Pennsylvania, Camden, Pennsylvania, USA.
Demetrius Lopes, Advocate Health - MidwestFollow
Gustavo Pradilla, Neurosurgery, Emory Univ, Atlanta, Georgia, USA.
Philipp Taussky, Neurosurgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Ahmed Kashkoush, Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Ajay K. Wakhloo, Radiology, Tufts Medical Center, Boston, Massachusetts, USA.
Adam S. Arthur, Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA.
J Mocco, The Mount Sinai Health System, New York, New York, USA.
David S. Liebeskind, Neurology, UCLA, Los Angeles, California, USA.
Edgar A. Samaniego, Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Gabor Toth, Cerebrovascular Center, CCF, Cleveland Heights, Ohio, USA.
Daniel Strbian, Department of Neurology, University of Helsinki, Helsinki, Finland.
Italo Linfante, Department of Neurology, Baptist Cardiac and Vascular Institute, Miami, Florida, USA.
Raul Nogueira, Department of Neurology, UPMC, Pittsburgh, Pennsylvania, USA.
Marc Fisher, Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Recommended Citation
Bain M, Kellner CP, Hanel RA, et al. Emerging approaches in the management of intracranial hemorrhage: ARISE II consensus recommendations. J Neurointerv Surg. Published online November 11, 2025. doi:10.1136/jnis-2025-023855
Abstract
Despite advances in the fundamental understanding of the pathophysiology of intracranial hemorrhage (ICH), many issues related to ICH management remain understudied with discrepancies in management. Given the high disease severity and prevalence, consensus recommendations are urgently needed to guide further research and management strategies. Thus, a group of clinical experts, industry leaders, and government representatives was assembled to examine emerging approaches in ICH management and their future impact on patient care. The timing of intervention within 24 hours and the role of minimally invasive evacuation, particularly for basal ganglia hemorrhage locations, were identified as key research focuses to guide future trial design. Mobile stroke units and artificial intelligence (AI) are promising technologies that streamline preoperative and triaging workflows and improve time to intervention. Efforts to further develop surgical technologies will be crucial to improve ICH visualization and evacuation. Further research, industry collaboration, and investment are needed to advance treatment frontiers and catalyze ICH research.
Affiliations
Advocate Aurora Health, Park Ridge