ICH Basics
Beyond motor and cognitive impairments, this psychological condition is frequently seen in ICH survivors and requires careful screening and management.
What is depression?
The immediate imaging modality of choice to differentiate ischemic stroke from hemorrhagic stroke.
What is a non-contrast CT scan of the head?
One common complication of ICH is the development of seizures, often requiring this type of medication.
What are anti-epileptic drugs (AEDs) (or anticonvulsants)?
This type of stroke has a significantly higher mortality and long-term disability rate.
What is hemorrhagic stroke?
This surgical procedure involves opening the skull to directly remove the hematoma.
What is a craniotomy?
The most common modifiable risk factor for ICH, accounting for over half of cases.
What is hypertension (high blood pressure)?
This crucial vital sign needs to be aggressively managed in ICH patients to prevent further bleeding and injury.
What is blood pressure?
This physiologic response, presenting with widening pulse pressure, bradycardia, and irregular respirations, can indicate rising intracranial pressure.
What is Cushing's Triad?
The primary goal of rehabilitation services after an ICH.
What is to maximize functional independence and quality of life?
This IV antihypertensive is commonly used for acute blood pressure management in ICH, due to its titratable, predictable effects.
What is nicardipine?
This scale is commonly used to predict 30-day mortality in patients with ICH, considering factors like GCS, ICH volume, and age.
What is the ICH Score?
A patient on warfarin presents with ICH. This immediate reversal agent is often administered, along with Vitamin K.
What is 4-factor Prothrombin Complex Concentrate (PCC)?
This electrolyte imbalance is a common complication in severe ICH, often due to SIADH or cerebral salt wasting.
What is hyponatremia?
These three consulting services are often involved in early stroke rehabilitation.
What are Physical Therapy (PT), Occupational Therapy (OT), and Speech-Language Pathology (SLP)?
For ICH patients with significant hydrocephalus, this emergent surgical procedure may be performed to drain CSF and relieve pressure.
What is an External Ventricular Drain (EVD) placement?
In ICH, this phenomenon describes the expansion of the hematoma within the first few hours after symptom onset, often seen on repeat imaging.
What is hematoma expansion?
This finding on a CT angiogram, described as areas of contrast extravasation within the hematoma, indicates ongoing active bleeding and is a strong predictor of hematoma expansion.
What is the "spot sign"?
This complication means blood has leaked from the ICH into the ventricular system, which can impair CSF flow and worsen outcomes.
What is intraventricular hemorrhage (IVH)?
46% of stroke patients suffer from this long term deficit, increasing the risk of aspiration pneumonia.
What is Post-Stroke Dysphagia?
This minimally-invasive intervention stops the blood flow to a cerebral artery through a skin puncture to contain hematoma expansion.
What is an embolization?
While non-traumatic, this common underlying pathology involves the buildup of amyloid protein in cerebral arteries, making them fragile and prone to rupture, especially in older adults.
What is Cerebral Amyloid Angiopathy (CAA)?
Beyond blood pressure, this other critical physiological parameter must be monitored and often treated to prevent secondary brain injury, especially if the patient is intubated.
What is intracranial pressure (ICP)? (Or managing cerebral perfusion pressure/CPP)
This target systolic blood pressure range is often aimed for within the first few hours of ICH onset, provided it doesn't compromise cerebral perfusion pressure.
What is 130-150 mmHg?
This neurological condition is characterized by involuntary, sudden, and often uncontrollable episodes of crying or laughing that are disproportionate to the patient's actual emotional state.
What is Pseudobulbar Affect (PBA)?
This hyperosmolar agent, given as a bolus, draws water from brain parenchyma into the vasculature to acutely reduce ICP.
What is hypertonic saline? (or mannitol)