Hemorrhagic stroke history and symptoms

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

History and symptoms

Hiistory

It is critical to obtain a detailed and focused history.

History	}Comments
Timing of the symptoms onset	The time the patient was last normal
Initial symptoms	The progression of symptoms
Vascular risk factors	Hypertension Diabetes Hypercholesterolemia Smoking
Medications	Anticoagulants Antiplatelet agents Decongestants Antihypertensive medications Stimulants (including diet pills) Sympathomimetics
Recent trauma or surgery	ICH may be related to hyperperfusion after Carotid endarterectomy Carotid stenting
Dementia	Associated with amyloid angiopathy
Alcohol or illicit drug use	Cocaine Other sympathomimetic drugs
Liver disease	Associated with coagulopathy
Cancer and hematologic disorders	Associated with coagulopathy

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 intracerebral hemorrhage include:

• Vomiting
• Systolic blood pressure >220 mm Hg
• Severe headache
• Coma
• Decreased level of consciousness
• Progression over minutes or hours

References

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