Hemorrhagic stroke primary prevention

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

Primary prevention

Primary prevention of hemorrhagic stroke is mainly aimed at treatment and modifcation of risk factors which are directly associated with increased occurence of hemorrhagic stroke. Effective measures for primary prevention of stroke include:

2014 AHA/ASA Guidelines for the Primary Prevention of Stroke

Genetic Factors: Recommendations

Class III (Harm)

"1. Genetic screening of the general population for prevention of a first stroke is not recommended (Level of Evidence: C)"

"2. Screening of patients at risk for myopathy in the setting of statin use is not recommended when considering initiation of statin therapy at this time(Level of Evidence: C)"

"3. Noninvasive screening for unruptured intracranial aneurysms in patients with >2 first-degree relatives with SAH or intracranial aneurysms might be reasonable (Level of Evidence: C)"

"4.Universal screening for intracranial aneurysms in carriers of mutations for Mendelian disorders associated with aneurysm is not recommended (Level of Evidence: C)"

"5. Dosing with vitamin K antagonists on the basis of pharmacogenetics is not recommended at this time(Level of Evidence: C)"

Class IIa

"1. Obtaining a family history can be useful to help identify persons who may be at increased risk of stroke (Level of Evidence: A)"

Class IIb

"1. Referral for genetic counseling may be considered for patients with rare genetic causes of stroke (Level of Evidence: C)"

"2. Treatment for certain genetic conditions that pre- dispose to stroke (eg, Fabry disease and enzyme replacement therapy) might be reasonable but has not been shown to reduce risk of stroke, and its effectiveness is unknown (Level of Evidence: C)"

"3. Noninvasive screening for unruptured intracranial aneurysms in patients with ADPKD and >1 relatives with ADPKD and SAH or intracranial aneurysm may be considered(Level of Evidence: C)"

"4. Noninvasive screening for unruptured intracranial aneurysms in patients with cervical fibromuscular dysplasia may be considered(Level of Evidence: C)"

References

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