After intracerebral haemorrhage, lower blood pressure cut repeat bleeding by more than half

The edition in brief

RECAP-ICH pooled individual data from four trials and 2944 survivors of spontaneous intracerebral haemorrhage, three-quarters Asian. An average 11 mm Hg lower systolic pressure reduced first recurrent stroke from 10.4% to 6.5% (adjusted HR 0.62) and recurrent haemorrhage from 5.6% to 2.2% (HR 0.39), with no excess of serious adverse events. Benefit was consistent across subgroups, and a 1% absolute gain accrued within about six months. A post hoc analysis of the CERTA trial found that in 76 critically ill adults without a primary neurological condition, continuous EEG did not change mortality, function or seizure detection compared with two routine recordings; no seizures were found in either group. A Lancet Neurology review sets out the unresolved questions — test accuracy at low prevalence, intermediate biomarker results, and the downstream effects on patients and systems — that will follow if anti-amyloid treatment is extended to cognitively unimpaired people with Alzheimer's pathology. A meta-analysis of 36 cohort studies associates sarcopenia with more than double the odds of poor functional outcome after stroke. The pearl covers when to suspect cerebral amyloid angiopathy behind a lobar bleed.