Intracranial hemorrhage: Difference between revisions
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(Created page with "== Management == * SBP <140-160 initially * For increased ICP: mannitol, hypertonic saline, raise head of bed, ensure normothermia and normoglycemia * Consult Neurosurgery *...") Â |
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* SBP <140-160 initially |
* SBP <140-160 initially |
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* For increased ICP: mannitol, hypertonic saline, raise head of bed, ensure normothermia and normoglycemia |
* For increased ICP: [[mannitol]], [[hypertonic saline]], raise head of bed, ensure normothermia and normoglycemia |
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* Consult Neurosurgery |
* Consult Neurosurgery |
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* For seizures, may not need to manage if first one is |
* For seizures, may not need to manage if first one is self-limited |
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* Reverse anticoagulations |
* Reverse anticoagulations |
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** Warfarin: vitamin K, PCC |
** [[Warfarin]]: [[vitamin K]], [[PCC]] |
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** Rivaroxaban and apixaban: andexanet alfa |
** [[Rivaroxaban]] and [[apixaban]]: [[andexanet alfa]] |
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** LMWH/UFH: [[protamine]] |
** [[LMWH]]/[[UFH]]: [[protamine]] |
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** [[Dabigatran]]: idarucizumab |
** [[Dabigatran]]: [[idarucizumab]] |
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* Intermittent pneumatic compression stockings for VTE prophylaxis |
* Intermittent pneumatic compression stockings for VTE prophylaxis |
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* Repeat imaging in |
* Repeat imaging in 24 hours |
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== Prevention == |
== Prevention == |
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* For [[cerebral amyloid angiopathy]], diagnose with the modified Boston criteria and refer to Neurology |
* For [[cerebral amyloid angiopathy]], diagnose with the modified Boston criteria and refer to Neurology |
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** Treating [[hypertension]] still helpful |
** Treating [[hypertension]] still helpful |
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* No need for statin unless otherwise indicated |
* No need for [[statin]] unless otherwise indicated |
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[[Category:Neurology]] |
[[Category:Neurology]] |
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Latest revision as of 13:43, 1 December 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 self-limited
- Reverse anticoagulations
- Intermittent pneumatic compression stockings for VTE prophylaxis
- Repeat imaging in 24 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
