intracranial hemorrhage

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Etiology

Radiology

  • CT of the head vs MRI
    • less expensive, faster, more available[1]

Complications

Management

reversal of anticoagulation

systolic blood pressure control

apparently, low dose aspirin may be continued[5]

anticonvulsants not indicated in to absence of seizure or epileptiform activity on EEG[5]

desmopressin associated with less hemorrhage expansion in antiplatelet- associated hemorrhage but no change in clinical outcome[6]

More general terms

More specific terms

References

  1. Jump up to: 1.0 1.1 1.2 Medical Knowledge Self Assessment Program (MKSAP) 16,18, 19. American College of Physicians, Philadelphia 2012, 2018, 2021
  2. Jump up to: 2.0 2.1 Poli D et al. Recurrence of ICH after resumption of anticoagulation with VK antagonists: CHIRONE Study. Neurology 2014 Feb 21; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24562060 <Internet> http://www.neurology.org/content/early/2014/02/21/WNL.0000000000000245
  3. Shin JY, Park MJ, Lee SH et al Risk of intracranial haemorrhage in antidepressant users with concurrent use of non-steroidal anti-inflammatory drugs: nationwide propensity score matched study. BMJ 2015;351:h3517 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26173947 <Internet> http://www.bmj.com/content/351/bmj.h3517
    Mercer SW et al Risk of intracranial haemorrhage linked to co-treatment with antidepressants and NSAIDs. BMJ 2015;351:h3745 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26173949 <Internet> http://www.bmj.com/content/351/bmj.h3745
  4. Jump up to: 4.0 4.1 4.2 Kritek P. New Guidelines on Reversal of Anticoagulants in Patients with Intracranial Hemorrhage. NEJM Journal Watch. Jan 17, 2017 Massachusetts Medical Society (subscription needed) http://www.jwatch.org
    Frontera JA, Lewin JJ 3rd, Rabinstein AA et al. Guideline for reversal of antithrombotics in intracranial hemorrhage: Executive summary. A statement for healthcare professionals from the Neurocritical Care Society and the Society of Critical Care Medicine. Crit Care Med 2016 Dec; 44:2251 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27858808
  5. Jump up to: 5.0 5.1 5.2 5.3 Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
  6. Jump up to: 6.0 6.1 Feldman EA, Meola G, Zyck S et al. Retrospective assessment of desmopressin effectiveness and safety in patients with antiplatelet-associated intracranial hemorrhage. Crit Care Med 2019 Sep 24; PMID: https://www.ncbi.nlm.nih.gov/pubmed/31567345