Hemorrhagic stroke laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Laboratory findings


Blood test	Test result	Rationale
Complete blood count and platelet	Leukocytosis Polycythemia Thrombocytopenia	Monitor for infection Assess hematocrit and platelet count to identify hemorrhagic risk and complications
Lipid profile	Increased LDL, triglycerides and cholesterol	May increase the risk of thromboembolic event^[1]^[2]^[3]
PT/APTT/INR	Increased PT/APTT/INR	Identify a coagulopathy
BUN/Creatinine	Increased BUN and creatinine	Mild to moderate renal dysfunction is an independant risk factor for ischemic stroke^[4]^[5] May be associated with poor prognosis in patients with ischemic stroke^[5]^[6]
Serum homocysteine level	Increased levels of serum homocysteine levels	May be associated with increased risk of thromboembolic event^[7]^[8]
Basic metabolic panel	Increased or decreased serum NA2+, K+, Ca2+	May mimic or complicate patients with ischemic stroke^[9]^[10]^[11]
HbA1C	Increased levels of HbA1c	May suggest control of diabetes in past few months Increased levels associated with increased risk of ischemic stroke^[12] May be associated with poor prognosis in patients with ischemic stroke
Blood glucose levels	Increased or decreased levels of blood glucose	Hyperglycemia is associated with poor prognosis of ischemic stroke^[13]^[14]^[15]^[16] Hypoglycemia may complicate or mimic patients with ischemic stroke^[17]
Cardiac enzymes	Increased serum levels of Trop I, Trop T, CK-MB	Elevated Trop T levels are associated with poor prognosis May suggest ongoing myocardial ischemia^[18]
Pregnancy test	Serum and urine B-HCG	Rule out pregnancy in all female patients with ischemic stroke since t-PA is a class C agent^[19]

References

↑ Willey JZ, Xu Q, Boden-Albala B, Paik MC, Moon YP, Sacco RL; et al. (2009). "Lipid profile components and risk of ischemic stroke: the Northern Manhattan Study (NOMAS)". Arch Neurol. 66 (11): 1400–6. doi:10.1001/archneurol.2009.210. PMC 2830863. PMID 19901173.
↑ Togha M, Gheini MR, Ahmadi B, Khashaiar P, Razeghi S (2011). "Lipid profile in cerebrovascular accidents". Iran J Neurol. 10 (1–2): 1–4. PMC 3829214. PMID 24250834.
↑ Lisak M, Demarin V, Trkanjec Z, Basić-Kes V (2013). "Hypertriglyceridemia as a possible independent risk factor for stroke". Acta Clin Croat. 52 (4): 458–63. PMID 24696996.
↑ Koren-Morag N, Goldbourt U, Tanne D (2006). "Renal dysfunction and risk of ischemic stroke or TIA in patients with cardiovascular disease". Neurology. 67 (2): 224–8. doi:10.1212/01.wnl.0000229099.62706.a3. PMID 16864812.
↑ ^5.0 ^5.1 Hao Z, Yang C, Liu M, Wu B (2014). "Renal dysfunction and thrombolytic therapy in patients with acute ischemic stroke: a systematic review and meta-analysis". Medicine (Baltimore). 93 (28): e286. doi:10.1097/MD.0000000000000286. PMC 4603096. PMID 25526464.
↑ Laible M, Horstmann S, Rizos T, Rauch G, Zorn M, Veltkamp R (2015). "Prevalence of renal dysfunction in ischaemic stroke and transient ischaemic attack patients with or without atrial fibrillation". Eur J Neurol. 22 (1): 64–9, e4–5. doi:10.1111/ene.12528. PMID 25091540.
↑ Yao ES, Tang Y, Xie MJ, Wang MH, Wang H, Luo X (2016). "Elevated Homocysteine Level Related to Poor Outcome After Thrombolysis in Acute Ischemic Stroke". Med Sci Monit. 22: 3268–73. PMC 5034885. PMID 27629768.
↑ Ashjazadeh N, Fathi M, Shariat A (2013). "Evaluation of Homocysteine Level as a Risk Factor among Patients with Ischemic Stroke and Its Subtypes". Iran J Med Sci. 38 (3): 233–9. PMC 3808947. PMID 24174694.
↑ Alam MN, Uddin MJ, Rahman KM, Ahmed S, Akhter M, Nahar N; et al. (2012). "Electrolyte changes in stroke". Mymensingh Med J. 21 (4): 594–9. PMID 23134903.
↑ Guven H, Cilliler AE, Koker C, Sarikaya SA, Comoglu SS (2011). "Association of serum calcium levels with clinical severity of acute ischemic stroke". Acta Neurol Belg. 111 (1): 45–9. PMID 21510233.
↑ Farahmand F, Choobi Anzali B, Heshmat R, Ghafouri HB, Hamedanchi S (2013). "Serum Sodium and Potassium Levels in Cerebro-vascular Accident Patients". Malays J Med Sci. 20 (3): 39–43. PMC 3743980. PMID 23966823.
↑ Oh HG, Rhee EJ, Kim TW, Lee KB, Park JH, Yang KI; et al. (2011). "Higher glycated hemoglobin level is associated with increased risk for ischemic stroke in non-diabetic korean male adults". Diabetes Metab J. 35 (5): 551–7. doi:10.4093/dmj.2011.35.5.551. PMC 3221032. PMID 22111048.
↑ Kagansky N, Levy S, Knobler H (2001). "The role of hyperglycemia in acute stroke". Arch Neurol. 58 (8): 1209–12. PMID 11493160.
↑ Bruno A, Liebeskind D, Hao Q, Raychev R, UCLA Stroke Investigators (2010). "Diabetes mellitus, acute hyperglycemia, and ischemic stroke". Curr Treat Options Neurol. 12 (6): 492–503. doi:10.1007/s11940-010-0093-6. PMC 2943579. PMID 20848328.
↑ Baker L, Juneja R, Bruno A (2011). "Management of hyperglycemia in acute ischemic stroke". Curr Treat Options Neurol. 13 (6): 616–28. doi:10.1007/s11940-011-0143-8. PMID 21861124.
↑ Gilmore RM, Stead LG (2006). "The role of hyperglycemia in acute ischemic stroke". Neurocrit Care. 5 (2): 153–8. PMID 17099262.
↑ Radermecker RP, Scheen AJ (2010). "Management of blood glucose in patients with stroke". Diabetes Metab. 36 Suppl 3: S94–9. doi:10.1016/S1262-3636(10)70474-2. PMID 21211743.
↑ Norris JW, Hachinski VC, Myers MG, Callow J, Wong T, Moore RW (1979). "Serum cardiac enzymes in stroke". Stroke. 10 (5): 548–53. PMID 505497.
↑ Grear KE, Bushnell CD (2013). "Stroke and pregnancy: clinical presentation, evaluation, treatment, and epidemiology". Clin Obstet Gynecol. 56 (2): 350–9. doi:10.1097/GRF.0b013e31828f25fa. PMC 3671374. PMID 23632643.

Template:WS Template:WH

[pmid19901173-1] Willey JZ, Xu Q, Boden-Albala B, Paik MC, Moon YP, Sacco RL; et al. (2009). "Lipid profile components and risk of ischemic stroke: the Northern Manhattan Study (NOMAS)". Arch Neurol. 66 (11): 1400–6. doi:10.1001/archneurol.2009.210. PMC 2830863. PMID 19901173.

[pmid24250834-2] Togha M, Gheini MR, Ahmadi B, Khashaiar P, Razeghi S (2011). "Lipid profile in cerebrovascular accidents". Iran J Neurol. 10 (1–2): 1–4. PMC 3829214. PMID 24250834.

[pmid24696996-3] Lisak M, Demarin V, Trkanjec Z, Basić-Kes V (2013). "Hypertriglyceridemia as a possible independent risk factor for stroke". Acta Clin Croat. 52 (4): 458–63. PMID 24696996.

[pmid16864812-4] Koren-Morag N, Goldbourt U, Tanne D (2006). "Renal dysfunction and risk of ischemic stroke or TIA in patients with cardiovascular disease". Neurology. 67 (2): 224–8. doi:10.1212/01.wnl.0000229099.62706.a3. PMID 16864812.

[pmid25526464-5] 5.0 ^5.1 Hao Z, Yang C, Liu M, Wu B (2014). "Renal dysfunction and thrombolytic therapy in patients with acute ischemic stroke: a systematic review and meta-analysis". Medicine (Baltimore). 93 (28): e286. doi:10.1097/MD.0000000000000286. PMC 4603096. PMID 25526464.

[pmid25091540-6] Laible M, Horstmann S, Rizos T, Rauch G, Zorn M, Veltkamp R (2015). "Prevalence of renal dysfunction in ischaemic stroke and transient ischaemic attack patients with or without atrial fibrillation". Eur J Neurol. 22 (1): 64–9, e4–5. doi:10.1111/ene.12528. PMID 25091540.

[pmid27629768-7] Yao ES, Tang Y, Xie MJ, Wang MH, Wang H, Luo X (2016). "Elevated Homocysteine Level Related to Poor Outcome After Thrombolysis in Acute Ischemic Stroke". Med Sci Monit. 22: 3268–73. PMC 5034885. PMID 27629768.

[pmid24174694-8] Ashjazadeh N, Fathi M, Shariat A (2013). "Evaluation of Homocysteine Level as a Risk Factor among Patients with Ischemic Stroke and Its Subtypes". Iran J Med Sci. 38 (3): 233–9. PMC 3808947. PMID 24174694.

[pmid23134903-9] Alam MN, Uddin MJ, Rahman KM, Ahmed S, Akhter M, Nahar N; et al. (2012). "Electrolyte changes in stroke". Mymensingh Med J. 21 (4): 594–9. PMID 23134903.

[pmid21510233-10] Guven H, Cilliler AE, Koker C, Sarikaya SA, Comoglu SS (2011). "Association of serum calcium levels with clinical severity of acute ischemic stroke". Acta Neurol Belg. 111 (1): 45–9. PMID 21510233.

[pmid23966823-11] Farahmand F, Choobi Anzali B, Heshmat R, Ghafouri HB, Hamedanchi S (2013). "Serum Sodium and Potassium Levels in Cerebro-vascular Accident Patients". Malays J Med Sci. 20 (3): 39–43. PMC 3743980. PMID 23966823.

[pmid22111048-12] Oh HG, Rhee EJ, Kim TW, Lee KB, Park JH, Yang KI; et al. (2011). "Higher glycated hemoglobin level is associated with increased risk for ischemic stroke in non-diabetic korean male adults". Diabetes Metab J. 35 (5): 551–7. doi:10.4093/dmj.2011.35.5.551. PMC 3221032. PMID 22111048.

[pmid11493160-13] Kagansky N, Levy S, Knobler H (2001). "The role of hyperglycemia in acute stroke". Arch Neurol. 58 (8): 1209–12. PMID 11493160.

[pmid20848328-14] Bruno A, Liebeskind D, Hao Q, Raychev R, UCLA Stroke Investigators (2010). "Diabetes mellitus, acute hyperglycemia, and ischemic stroke". Curr Treat Options Neurol. 12 (6): 492–503. doi:10.1007/s11940-010-0093-6. PMC 2943579. PMID 20848328.

[pmid21861124-15] Baker L, Juneja R, Bruno A (2011). "Management of hyperglycemia in acute ischemic stroke". Curr Treat Options Neurol. 13 (6): 616–28. doi:10.1007/s11940-011-0143-8. PMID 21861124.

[pmid17099262-16] Gilmore RM, Stead LG (2006). "The role of hyperglycemia in acute ischemic stroke". Neurocrit Care. 5 (2): 153–8. PMID 17099262.

[pmid21211743-17] Radermecker RP, Scheen AJ (2010). "Management of blood glucose in patients with stroke". Diabetes Metab. 36 Suppl 3: S94–9. doi:10.1016/S1262-3636(10)70474-2. PMID 21211743.

[pmid505497-18] Norris JW, Hachinski VC, Myers MG, Callow J, Wong T, Moore RW (1979). "Serum cardiac enzymes in stroke". Stroke. 10 (5): 548–53. PMID 505497.

[pmid23632643-19] Grear KE, Bushnell CD (2013). "Stroke and pregnancy: clinical presentation, evaluation, treatment, and epidemiology". Clin Obstet Gynecol. 56 (2): 350–9. doi:10.1097/GRF.0b013e31828f25fa. PMC 3671374. PMID 23632643.

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Hemorrhagic stroke laboratory findings

Overview

Laboratory findings

References

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