STROKE-ICH (INTRACEREBRAL HAEMORRHAGE)
SUMMARY
1. Intracerebral haemorrhage (ICH): 13% of all strokes may be secondary to HTN, amyloid angiopathy, ruptured aneurysm, AVM, bleeding disorders, anticoagulants, bleeding into tumors.
2. Amyloid angiopathy is a common cause of hemorrhagic stroke after the 5th decade of life.
3. Some patients have pre-existing evidence of intermittent, small bleeds on MRI of the brain, these "microbleeds" are indicators of which patients are prone to future ICH.
4. The hemorrhage tends to be lobar and subcortical and can be multiple. It rarely involves the deep structures.
5. Gradual or sudden onset with deficit worse at onset.
6. Hemorrhages may recur within months or years.
7. Dementia occurs in 30%. Other features include acute reactive hypertension, vomiting, headache, and nuchal rigidity.
Reference(s)
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
