AHA, ASA guidelines for the management of spontaneous intracerebral hemorrhage
Hemorrhagic stroke Microchapters |
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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 |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
2015 AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage[1]
Hemostasis and Coagulopathy, Antiplatelet Agents, and DVT Prophylaxis: Recommendations
Surgical Treatment of ICH: Recommendations
Class I |
"1.Patients with cerebellar hemorrhage who are deteriorating neurologically or who have brainstem compression and/or hydrocephalus from ventricular obstruction should undergo surgical removal of the hemorrhage as soon as possible (Level of Evidence: B)" |
Class III (Harm) |
"1. Initial treatment of patients with cerebellar hemorrhage who are deteriorating neurologically or who have brainstem compression and/or hydrocephalus from ventricular obstruction is not recommended (Level of Evidence: C)" |
Class IIb |
"1. For most patients with supratentorial ICH, the usefulness of surgery is not well established (Level of Evidence: A)" |
"2. A policy of early hematoma evacuation is not clearly beneficial compared with hematoma evacution when patients deteriorate (Level of Evidence: A)" |
"3. Supratentorial hematoma evacuation in deteriorating patients might be considered as a life-saving measure (Level of Evidence: C)" |
"4.Decompressive hemicraniectomy (DC) with or without hematoma evacuation might reduce mortality for patients with supratentorial ICH who are in a coma, have large hematomas with significant midline shift, or have elevated ICP refractory to medical management (Level of Evidence: C)" |
"5. The effectiveness of minimally invasive clot evacuation with stereotactic or endoscopic aspiration with or without thrombolytic usage is uncertain (Level of Evidence: B)" |
Outcome Prediction and Withdrawal of Technological Support: Recommendation
Class III (Harm) |
"1. Current prognostic models for individual patients early after ICH are biased by failure to account for the influence of withdrawal of support and early DNAR orders. DNAR status should not limit appropriate medical and surgical interventions unless otherwise explicitly indicated (Level of Evidence: C)" |
Class IIa |
"1. Aggressive care early after ICH onset and postponement of new DNAR orders until at least the second full day of hospitalization is probably recommended. Patients with preexisting DNAR orders are not included in this recommendation (Level of Evidence: B)" |
References
- ↑ 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