Hemorrhagic Stroke Questions & Answers

Updated: Apr 22, 2019
  • Author: David S Liebeskind, MD, FAAN, FAHA, FANA; Chief Editor: Andrew K Chang, MD, MS  more...
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Questions & Answers

Overview

What is hemorrhagic stroke?

What are the signs and symptoms of hemorrhagic stroke?

What are deficits of hemorrhagic stroke characteristic of involvement of the left hemisphere of the brain?

What are deficits of hemorrhagic stroke characteristic of involvement of the right hemisphere of the brain?

Which lab tests are performed in the evaluation of hemorrhagic stroke?

What is the role of brain imaging in the evaluation of suspected hemorrhagic stroke?

What is included in the treatment of acute hemorrhagic stroke?

What is the role of surgery in the management of hemorrhagic stroke?

What is the role of endovascular therapy for the treatment of hemorrhagic stroke?

What is hemorrhagic stroke?

What are the clinical presentations of hemorrhagic stroke?

When is brain imaging performed in the evaluation of hemorrhagic stroke?

What anatomy is useful for the understanding of hemorrhagic stroke?

What is the anatomy of the brain involved in hemorrhagic stroke?

What is the pathophysiology of hemorrhagic stroke?

What is the role of subarachnoid hemorrhage (SAH) in the pathogenesis of hemorrhagic stroke?

How are the etiologies of hemorrhagic stroke categorized?

Which factors increase the risk of hemorrhagic stroke?

What are the causes of hemorrhagic stroke?

What is the most common etiology of primary hemorrhagic stroke?

What is the role of amyloidosis in the etiology of hemorrhagic stroke?

What is the role of coagulopathy in the etiology of hemorrhagic stroke?

What is the role of anticoagulant therapy in the etiology of hemorrhagic stroke?

What is the role of arteriovenous malformations in the etiology of hemorrhagic stroke?

What is the role of aneurysm in the etiology of hemorrhagic stroke?

What are common sites of aneurysms associated with hemorrhagic stroke?

What is the role of genetics in the etiology of hemorrhagic stroke?

What is Loeys-Dietz syndrome (LDS)?

What is the role of Ehlers-Danlos syndrome in the etiology of hemorrhagic stroke?

Where can information on genetics and hemorrhagic stroke be found?

What is the role of hemorrhagic transformation in the etiology of stroke?

What is the incidence of hemorrhagic stroke in the US?

What are the demographic variations in the prevalence of hemorrhagic stroke in the US?

What is the global incidence of hemorrhagic stroke?

What are the racial predilections of hemorrhagic stroke?

What is the prognosis of hemorrhagic stroke?

What is the intracerebral hemorrhage score and how is it calculated for hemorrhagic stroke?

How are the intracerebral hemorrhage scores for the prognosis of hemorrhagic stroke interpreted?

What are prognostic factors for hemorrhagic stroke?

How should Do Not Resuscitate (DNR) orders be handled in patients with hemorrhagic stroke?

Presentation

What is the focus of medical history in patients with hemorrhagic stroke?

What are hemorrhagic and ischemic stroke differentiated?

What are focal symptoms of hemorrhagic stroke?

What are symptoms of subarachnoid hemorrhage (SAH) in hemorrhagic stroke?

What are the most common clinical scoring systems for grading aneurysmal subarachnoid hemorrhage (SAH) in hemorrhagic stroke?

What is included in the assessment of suspected hemorrhagic stroke?

What are physical findings characteristic of hemorrhagic stroke?

How are physical exam results quantified for hemorrhagic stroke?

Which neurologic deficits are associated with hemorrhagic stroke in the left brain hemisphere?

Which neurologic deficits are associated with hemorrhagic stroke in the right brain hemisphere?

What can result from nondominant hemisphere syndrome in hemorrhagic stroke?

What are the indications of cerebellum involvement in hemorrhagic stroke?

What are the specific brain site deficits of hemorrhagic stroke?

What are signs of cerebellar or brainstem involvement in hemorrhagic stroke?

DDX

How is hemorrhagic stroke differentiated from ischemic stroke?

What are the differential diagnoses for Hemorrhagic Stroke?

Workup

What is the role of lab testing in the diagnosis of hemorrhagic stroke?

What is the role of brain imaging in the evaluation of hemorrhagic stroke?

What is the role of CT scanning in the diagnosis of hemorrhagic stroke?

When is CT angiography and contrast-enhanced CT indicated in the workup of hemorrhagic stroke?

What is the role of angiography in the diagnosis of hemorrhagic stroke?

What is the role of MRA in the evaluation of hemorrhagic stroke?

Treatment

What is included in the treatment of acute hemorrhagic stroke depend on?

What is the initial management of hemorrhagic stroke?

What is effective targeted therapy for hemorrhagic stroke?

How does intensive blood pressure reduction affect hematomas in hemorrhagic stroke?

What is the prevalence of seizures in hemorrhagic stroke?

How are seizures treated in hemorrhagic stroke?

What is the role of prophylactic anticonvulsant medication in hemorrhagic stroke?

What are the AHA/ASA guidelines for the use of prophylactic anticonvulsant medication in the treatment of hemorrhagic stroke?

What is optimal blood pressure (BP) control in hemorrhagic stroke?

What is the role of blood pressure (BP) reduction in the treatment of hemorrhagic stroke?

Which medications are useful to reduce blood pressure (BP) in the treatment of hemorrhagic stroke?

What are the AHA/ASA guidelines for treating elevated blood pressure (BP) in hemorrhagic stroke?

What are the AHA/ASA guidelines for BP management in patients with aneurysmal subarachnoid hemorrhage (SAH)?

What are the ACP/AAFP treatment guidelines for persistent systolic blood pressure (BP) in the prevention of hemorrhagic stroke?

What is the cause of elevated intracranial pressure in hemorrhagic stroke?

What are the options for intracranial pressure control in hemorrhagic stroke?

What is the role of hemostatic therapy for hemorrhagic stroke?

What is the efficacy of hemostatic therapy in the treatment of hemorrhagic stroke?

How is the risk of hemorrhagic stroke increased in patients on warfarin?

What are the options for warfarin reversal in patients with hemorrhagic stroke?

What is the difference between using fresh frozen plasma (FFP) and prothrombin complex concentrates (PCC) for the treatment of hemorrhagic stroke?

What is the role of recombinant factor VIIa (rFVIIa) in the treatment of hemorrhagic stroke?

What are the treatment options for hemorrhagic stroke caused by platelet dysfunction?

What is the benefit of statin use in the treatment of hemorrhagic stroke?

What is the role of statins in the treatment of hemorrhagic stroke?

When is surgery indicated in the treatment of hemorrhagic stroke?

Which factors improve the outcome of surgery treatment of hemorrhagic stroke?

What is the benefit of surgical intervention in a cerebellar hemorrhagic stroke?

What is the role of endovascular therapy in the treatment of hemorrhagic stroke?

What is the efficacy of endovascular coiling for the treatment of hemorrhagic stroke?

What are the benefits of endovascular coil embolization compared with microsurgical clipping in the treatment of aneurysm in hemorrhagic stroke?

When is endovascular treatment of aneurysms indicated in the treatment of hemorrhagic stroke?

When is endovascular treatment of aneurysms contraindicated in hemorrhagic stroke?

What is the efficacy of combining medication and balloon angioplasty in the treatment of hemorrhagic stroke?

What is the role of ventriculostomy in the treatment of hemorrhagic stroke?

What are the AHA/ASA treatment guidelines for spontaneous intracranial hemorrhage (ICH) in hemorrhagic stroke?

Which medications are used to lower blood pressure (BP)-in the treatment of hemorrhagic stroke?

What are possible adverse effects of statin therapy in the treatment of hemorrhagic stroke?

What is the role of antiplatelet therapy in the prevention of hemorrhagic stroke?

What is the role of perindopril in the prevention of hemorrhagic stroke?

How does chlorthalidone compare to lisinopril for the prevention of hemorrhagic stroke?

How does losartan compare to atenolol for the prevention of hemorrhagic stroke?

How does nitrendipine compare to eprosartan for the prevention of hemorrhagic stroke?

What are the lifestyle interventions for prevention of hemorrhagic stroke?

What is the role of exercise in the prevention of hemorrhagic stroke?

Which specialist consultation are needed for the management of hemorrhagic stroke?

Medications

Which medications are used in the treatment of hemorrhagic stroke?

What factors determine the treatment approach for hemorrhagic stroke?

Which medications in the drug class Vasopressin-Related are used in the treatment of Hemorrhagic Stroke?

Which medications in the drug class Antidotes, Other are used in the treatment of Hemorrhagic Stroke?

Which medications in the drug class Blood Components are used in the treatment of Hemorrhagic Stroke?

Which medications in the drug class Hemostatics are used in the treatment of Hemorrhagic Stroke?

Which medications in the drug class Analgesics, Other are used in the treatment of Hemorrhagic Stroke?

Which medications in the drug class Diuretics, Osmotic Agents are used in the treatment of Hemorrhagic Stroke?

Which medications in the drug class Diuretics, Thiazide are used in the treatment of Hemorrhagic Stroke?

Which medications in the drug class Angiotensin Receptor Blockers are used in the treatment of Hemorrhagic Stroke?

Which medications in the drug class Angiotensin-converting Enzyme Inhibitors are used in the treatment of Hemorrhagic Stroke?

Which medications in the drug class Calcium Channel Blockers are used in the treatment of Hemorrhagic Stroke?

Which medications in the drug class Vasodilators are used in the treatment of Hemorrhagic Stroke?

Which medications in the drug class Beta Blockers, Beta-1 Selective are used in the treatment of Hemorrhagic Stroke?

Which medications in the drug class Beta Blockers, Alpha Activity are used in the treatment of Hemorrhagic Stroke?

Which medications in the drug class Anticonvulsants, Hydantoins are used in the treatment of Hemorrhagic Stroke?

Which medications in the drug class Anticonvulsants, Other are used in the treatment of Hemorrhagic Stroke?