Hemorrhagic stroke laboratory findings

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AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage (2015) Management of ICH
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Routine laboratory studies in patient with intracerebral hemorrhage should include complete blood count (CBC) with platelets, electrolytes, renal function, coagulation studies (prothrombin time (PT), partial thromboplastin time (PTT), and INR), toxicology screen, blood glucose level, and pregnancy test in women of childbearing age.

Laboratory findings

Laboratory findings for intracerebral hemorrhage may include the following:

Blood test	Test result	Rationale
Complete blood count and platelet	Leukocytosis Polycythemia Thrombocytopenia	Monitor for infection Assess hematocrit and platelet count to identify hemorrhagic risk and complications
BMP/Osmolarity	Increased or decreased serum NA2+, K+, Ca2+ Change in osmolarity	Monitor osmolarity for guidance of osmotic diuresis
PT/APTT/INR	Increased PT/APTT/INR	Identify a coagulopathy
BUN/Creatinine	Increased BUN and creatinine	May be associated with poor prognosis in patients with intracerebral hemorrhage and hematoma expansion
Toxicology screen/Serum alcohol level	Increased levels of serum	Identify illicit drug use or excessive alcohol Identify exogenous toxins that can cause intracerebral hemorrhage (ICH)
HbA1C	Increased levels of HbA1c
Blood glucose levels	Increased or decreased levels of blood glucose	May be associated with poor prognosis in patients with Intracerebral hemorrhage
Cardiac enzymes	Increased serum levels of Trop I, Trop T, CK-MB	Elevated Trop T levels are associated with poor prognosis May suggest ongoing myocardial ischemia
Pregnancy test	Serum and urine B-HCG	Rule out pregnancy in all female patients with hemorrhagic stroke

References

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