Hanying Xu,1,* Jing Lu,2,* Xiaolei Tang,2 Pengfei Li,3 Lei Wu,4 Jian Wang,1 Ying Zhang,1 Dongmei Zhang5 

1Department of Encephalopathy, the Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, People’s Republic of China; 2Research Center of Traditional Chinese Medicine, the Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, People’s Republic of China; 3Department of Nephrology, the Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, People’s Republic of China; 4Department of Encephalopathy Rehabilitation, the Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, People’s Republic of China; 5Scientific Research Office, the Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ying Zhang, Department of Encephalopathy, The Affiliated Hospital of Changchun University of Chinese Medicine, 1478 Gongnong Street, Changchun, Jilin, 130021, People’s Republic of China, Email 18604460311@163.com Dongmei Zhang, Scientific Research Office, The Affiliated Hospital of Changchun University of Chinese Medicine, 1478 Gongnong Street, Changchun, Jilin, 130021, People’s Republic of China, Email zhangdongmei1124@126.com

Abstract: Intracerebral hemorrhage (ICH) is a severe cerebrovascular disorder associated with high morbidity and mortality. Ferroptosis, a regulated form of cell death characterized by iron accumulation and lipid peroxidation, plays a critical role in secondary injury following ICH. Traditional Chinese Medicine (TCM) has demonstrated distinct therapeutic benefits in cerebrovascular disease, and emerging evidence suggests its potential to modulate ferroptosis. This review explores the therapeutic effects of TCM and TCM-based interventions for ICH, with a focus on their regulation of ferroptosis-related mechanisms. In ICH, ferroptosis is driven by disrupted iron metabolism, lipid peroxidation, oxidative stress, and neuroinflammation—key contributors to secondary brain injury. TCM interventions, including herbal medicines, active compounds, and acupuncture, may counteract these processes by restoring iron homeostasis and reducing oxidative stress, thereby improving neurological outcomes. Given the critical role of ferroptosis in ICH pathophysiology, TCM represents a promising avenue for targeting ferroptosis-related pathways and advancing therapeutic strategies.

Keywords: cell death, iron deposition, lipid peroxidation, acupuncture, traditional Chinese medicine