Table 1 Characteristics of the included studies

Liu 2021 (TRAIGE)

Acute supratentorial intracerebral hemorrhage, indication of hemorrhage expansion on imaging, treatable within 8 h of symptom onset

ICH secondary to tumor, trauma, aneurysm, vascular malformation, hemorrhagic conversion of ischemic stroke, venous sinus thrombosis or central nervous system infection, use of oral anticoagulant therapy with abnormal laboratory values, infratentorial ICH, GCS score < 8, ICH volume > 70 mL, hemorrhage expanding to fill one side of the lateral ventricle or more than half of both lateral ventricles, clinical history or current evidence suggestive of venous or arterial thrombotic events

Intravenous tranexamic acid 1 g in 100 mL 0.9% NaCl over 10 min followed by 1 g in 250 mL 0.9% NaCl infusion over 8 h

N = 89

N = 82

Sprigg 2018 (TICH2)

Adults with acute intracerebral hemorrhage, admitted within 8 h of stroke symptom onset

ICH secondary to anticoagulation, thrombolysis, trauma, or known underlying structural abnormality; prestroke dependence (mRS > 4); life expectancy < 3 months; GCS score < 5

Intravenous tranexamic acid 1 g in 100 mL normal saline 0.9% over 10 min, followed by another 1 g in 250 mL normal saline 0.9% over 8 h

N = 1161

N = 1164

Yassi 2024 (STOP–MSU)

Adults with acute spontaneous intracerebral hemorrhage confirmed on non-contrast CT, treated within 2 h of stroke symptom onset

Baseline Glasgow Coma Scale score < 8, brainstem hemorrhage, hematoma volume > 70 mL, recent use of anticoagulants, hemorrhage due to trauma or other secondary causes

Intravenous tranexamic acid 1 g over 10 min followed by 1 g over 8 h

N = 103

N = 98

Meretoja 2020 (STOP–AUST)

Aged 18 years or older, acute intracerebral hemorrhage with a spot sign on CT angiography, treatable within 4.5 h of symptom onset and within 1 h of CT angiography

Glasgow Coma Scale score < 8, contraindications for antifibrinolytic therapy, ICH > 70 mL, brainstem hemorrhage, ICH secondary to trauma, aneurysm, vascular malformation, hemorrhagic transformation of ischemic stroke, cerebral venous thrombosis, thrombolytic therapy, tumor, or infection, thromboembolic events in the past 12 months, planned surgery within 24 h, use of anticoagulation agents, pregnancy, concurrent use of hemostatic agents

Intravenous tranexamic acid 1 g in 100 mL 0.9% NaCl over 10 min followed by 1 g in 500 mL 0.9% NaCl infusion over 8 h

N= 50

N = 50

Sprigg 2013

Adult patients with acute (< 24 h after ictus) spontaneous ICH

Secondary ICH (anticoagulation, known vascular malformations), previous venous thromboembolic disease, recent (< 12 months) ischemic events, renal impairment, and pregnancy or breast feeding

Intravenous tranexamic acid 1 g loading dose infusion for 10 min followed by a 1 g infusion for 8 h

N = 16

N = 8