Jones FJS, Sanches PR, Smith JR, et al. - In the present study, the researchers sought to assess which of 4 seizure prophylaxis strategies provides the greatest net benefit for patients with spontaneous intracerebral hemorrhage (sICH). The following 4 antiseizure drug strategies were involved: conservative, consisting of short-term (7-day) secondary early-seizure prophylaxis with long-term therapy after late seizure; moderate, consisting of long-term secondary early-seizure prophylaxis or late-seizure therapy; aggressive, consisting of long-term primary prophylaxis; and risk guided, consisting of short-term secondary early-seizure prophylaxis among low-risk patients (2HELPS2B score, 0), short-term primary prophylaxis among patients at higher risk (2HELPS2B score, ≥ 1), and long-term secondary therapy for late seizure. According to this decision analytical model, short-term (7-day) prophylaxis trumps longer-term therapy after sICH. The use of the 2HELPS2B score to guide clinical decisions for initiation of short-term primary vs secondary early-seizure prophylaxis after sICH should be considered for all patients.