Hemorrhagic stroke CT

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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]; 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 is very sensitive for identifying acute hemorrhage and is considered the gold standard.

CT

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 is very sensitive for identifying acute hemorrhage and is considered the gold standard.

Images

The following are images associated with Hemorrhagic stroke.

• 
  Large hemorrhagic focus in the left cerebral hemisphere that extends to the infratentorial region with a significant mass effect
• 
  Large hemorrhagic focus in the left cerebral hemisphere that extends to the infratentorial region with a significant mass effect
• 
  Multiple descrete bilateral supratentorial intraparenchymal cerebral haemorrhage
• 
  Very large intracerebral haemorrhage on the left extends to involve the ventricles. It exerts marked mass effect
• 
  Hemorrhagic stroke in the left basal ganglia

2015 AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage=

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

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