Intracranial hemorrhage: Difference between revisions
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Revision as of 08:42, 1 October 2021
Management
- SBP <140-160 initially
- For increased ICP: mannitol, hypertonic saline, raise head of bed, ensure normothermia and normoglycemia
- Consult Neurosurgery
- For seizures, may not need to manage if first one is selflimiting
- Reverse anticoagulations
- Warfarin: vitamin K, PCC
- Rivaroxaban and apixaban: andexanet alfa
- LMWH/UFH: protamine
- Dabigatran: idarucizumab
- Intermittent pneumatic compression stockings for VTE prophylaxis
- Repeat imaging in __ hours
Prevention
- Manage risk factors, especially hypertension (target BP <130/80 based on SPS3 trial)
- Lower alcohol intake, smoking cessation
- Improve diet, increase physical activity, lower sodium intake
- For cerebral amyloid angiopathy, diagnose with the modified Boston criteria and refer to Neurology
- Treating hypertension still helpful
- No need for statin unless otherwise indicated
