There is still hope that recombinant factor VIIa (rFVIIa) may be an effective hemostatic treatment for acute intracerebral hemorrhage (ICH) under the right conditions.[1] The slogan "time is brain" applies again, this time to control bleeding in the brain.[1] rFVIIa showed promise in a phase 2b clinical trial, where a dose of 80 μg/kg administered within 4 hours of symptom onset led to positive results.[1] However, the fastest administration of the drug is not optimal.[1] Treatment of intracerebral hemorrhage also includes timely reduction of elevated blood pressure.[1][3] In 38% of patients with hypertensive ICH examined within 3 hours of onset, CT showed significant bleeding progression.[1] The ATACH and INTERACT studies confirmed that a rapid reduction in pressure in the first hours reduces the growth of the hematoma.[1]