Hemorrhagic stroke emergency diagnosis and assessment
|
Hemorrhagic stroke Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage (2015) |
|
AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012) |
|
AHA/ASA Guideline Recommendation for the Primary Prevention of Stroke (2014) |
|
AHA/ASA Guideline Recommendations for Prevention of Stroke in Women (2014) Sex-Specific Risk Factors
Risk Factors Commoner in Women |
|
Case Studies |
|
Hemorrhagic stroke emergency diagnosis and assessment On the Web |
|
American Roentgen Ray Society Images of Hemorrhagic stroke emergency diagnosis and assessment |
|
FDA on Hemorrhagic stroke emergency diagnosis and assessment |
|
CDC on Hemorrhagic stroke emergency diagnosis and assessment |
|
Hemorrhagic stroke emergency diagnosis and assessment in the news |
|
Blogs on Hemorrhagic stroke emergency diagnosis and assessment |
|
Risk calculators and risk factors for Hemorrhagic stroke emergency diagnosis and assessment |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Intracerebral hemorrhage is a medical emergency, characterized by high morbidity and mortality, which should be promptly diagnosed and aggressively managed. Hematoma expansion and early deterioration are common within the first few hours after onset. CT and magnetic resonance imaging (MRI) are both reasonable for initial evaluation.[1]
Emergency diagnosis and assessment
Intracerebral hemorrhage is a medical emergency, characterized by high morbidity and mortality, which should be promptly diagnosed and aggressively managed. Hematoma expansion and early deterioration are common within the first few hours after onset.
- CT and magnetic resonance imaging (MRI) are both reasonable for initial evaluation. CT is very sensitive for identifying acute hemorrhage and is considered the gold standard
- Gradient echo and T2* susceptibility-weighted MRI are as sensitive as CT for detection of acute hemorrhage and are more sensitive for identification of prior hemorrhage.
2015 AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage[2]
Emergency Diagnosis and Assessment: Recommendations
| Class I |
| "1.A baseline severity score should be performed as part of the initial evaluation of patients with intracerebral hemorrhage (ICH) (Level of Evidence: B)" |
| "2.Rapid neuroimaging with CT or MRI is recommended to distinguish ischemic stroke from intracerebral hemorrhage (ICH) (Level of Evidence: A)" |
| Class IIa |
| "1.CT angiography, CT venography, contrast-enhanced CT, contrast-enhanced MRI, MRA and MRV can be useful to evaluate for underlying structural lesions including vascular malformations and tumors when there is clinical or radiologic suspicion (Level of Evidence: B)" |
| Class IIb |
| "1.CT angiography and contrast-enhanced CT may be considered to help identify patients at risk for hematoma expansion (Level of Evidence: B)" |
References
- ↑ Chalela JA, Kidwell CS, Nentwich LM, Luby M, Butman JA, Demchuk AM; et al. (2007). "Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison". Lancet. 369 (9558): 293–8. doi:10.1016/S0140-6736(07)60151-2. PMC 1859855. PMID 17258669.
- ↑ 2015 AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhagehttp://stroke.ahajournals.org/content/early/2015/05/28/STR.0000000000000069 Accessed on November 10, 2016