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==Overview==
==Overview==

Latest revision as of 18:13, 8 December 2016

Hemorrhagic stroke Microchapters

Main Stroke Page

Ischemic Stroke Page

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Stroke from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

Emergency Diagnosis and Assessment

History and Symptoms

Physical Examination

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Treatment

Early Assessment

NIH Stroke Scale

Management

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Primary Prevention

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Cost-Effectiveness of Therapy

Future or Investigational Therapies

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

Management of ICH

AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012)

Management of aSAH

AHA/ASA Guideline Recommendation for the Primary Prevention of Stroke (2014)

Primary Prevention of Stroke

AHA/ASA Guideline Recommendations for Prevention of Stroke in Women (2014)

Overview

Sex-Specific Risk Factors

Pregnancy and Complications
Cerebral Venous Thrombosis
Oral Contraceptives
Menopause and Postmenopausal Hormonal Therapy

Risk Factors Commoner in Women

Migraine with Aura
Obesity, Metabolic Syndrome, and Lifestyle Factors
Atrial Fibrillation

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Case #1

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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

History and symptoms

History

It is critical to obtain a detailed and focused history.[1][2][3][4][5][6]

History Comments
Timing of the symptoms onset
  • The time the patient was last normal
Initial symptoms
  • The progression of symptoms
Vascular risk factors
Medications
Recent trauma or surgery
Dementia
Alcohol or illicit drug use
  • Cocaine
  • Other sympathomimetic drugs
Liver disease
Cancer and hematologic disorders

Symtoms

It is impossible to know whether symptoms are due to ischemia or hemorrhage based on clinical characteristics alone. The abrupt onset of focal neurologic symptoms is presumed to be vascular in origin.

Non specific symptoms of hemorrhagic stroke may include the following:[7][8]

References

  1. Huhtakangas J, Tetri S, Juvela S, Saloheimo P, Bode MK, Hillbom M. Effect of increased warfarin use on warfarin-related cerebral hemor- rhage: a longitudinal population-based study. Stroke. 2011;42:2431– 2435. doi: 10.1161/STROKEAHA.111.615260.
  2. Rådberg JA, Olsson JE, Rådberg CT. Prognostic parameters in sponta- neous intracerebral hematomas with special reference to anticoagulant treatment. Stroke. 1991;22:571–576. doi: 10.1161/01.STR.22.5.571.
  3. Flaherty ML, Kissela B, Woo D, Kleindorfer D, Alwell K, Sekar P, Moomaw CJ, Haverbusch M, Broderick JP. The increasing incidence of anticoagulant-associated intracerebral hemorrhage. Neurology. 2007;68:116–121. doi: 10.1212/01.wnl.0000250340.05202.8b.
  4. Ariesen MJ, Claus SP, Rinkel GJ, Algra A (2003). "Risk factors for intracerebral hemorrhage in the general population: a systematic review". Stroke. 34 (8): 2060–5. doi:10.1161/01.STR.0000080678.09344.8D. PMID 12843354.
  5. Bos MJ, Koudstaal PJ, Hofman A, Breteler MM (2007). "Decreased glomerular filtration rate is a risk factor for hemorrhagic but not for ischemic stroke: the Rotterdam Study". Stroke. 38 (12): 3127–32. doi:10.1161/STROKEAHA.107.489807. PMID 17962600.
  6. Hackam DG, Mrkobrada M (2012). "Selective serotonin reuptake inhibitors and brain hemorrhage: a meta-analysis". Neurology. 79 (18): 1862–5. doi:10.1212/WNL.0b013e318271f848. PMID 23077009. Review in: Evid Based Ment Health. 2013 May;16(2):54
  7. Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF (2001). "Spontaneous intracerebral hemorrhage". N Engl J Med. 344 (19): 1450–60. doi:10.1056/NEJM200105103441907. PMID 11346811.
  8. Fisher CM (1971). "Pathological observations in hypertensive cerebral hemorrhage". J Neuropathol Exp Neurol. 30 (3): 536–50. PMID 4105427.


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