Intracranial hemorrhage medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
[[Pharmacologic]] therapy in patients with intracranial hemorrhage includes the administration of agents to reverse the underlying [[Coagulopathy|coagulopathies]]. Other measures that should be taken into account while managing [[patients]] with intracranial hemorrhage include the [[Airway management|management of airway]], [[intracranial pressure]], and [[seizure]]. | |||
==Medical Therapy== | ==Medical Therapy== | ||
Pharmacologic therapy in patients with intracranial hemorrhage include:<ref name="CaceresGoldstein2012">{{cite journal|last1=Caceres|first1=J. Alfredo|last2=Goldstein|first2=Joshua N.|title=Intracranial Hemorrhage|journal=Emergency Medicine Clinics of North America|volume=30|issue=3|year=2012|pages=771–794|issn=07338627|doi=10.1016/j.emc.2012.06.003}}</ref> | Pharmacologic therapy in [[patients]] with intracranial hemorrhage include:<ref name="CaceresGoldstein2012">{{cite journal|last1=Caceres|first1=J. Alfredo|last2=Goldstein|first2=Joshua N.|title=Intracranial Hemorrhage|journal=Emergency Medicine Clinics of North America|volume=30|issue=3|year=2012|pages=771–794|issn=07338627|doi=10.1016/j.emc.2012.06.003}}</ref> | ||
* Hemostatic therapy to correct the underlying coagulopathies. Agents that can be used to achieve this goal may differ based on the oral anticoagulant agent which resulted in the bleeding complications. | * Hemostatic therapy to correct the underlying [[coagulopathies]]. Agents that can be used to achieve this goal may differ based on the oral [[Anticoagulants|anticoagulant]] agent which resulted in the [[bleeding]] complications. | ||
* The following agents can be used for warfarin reversal:<ref name="SteinerRosand2006">{{cite journal|last1=Steiner|first1=Thorsten|last2=Rosand|first2=Jonathan|last3=Diringer|first3=Michael|title=Intracerebral Hemorrhage Associated With Oral Anticoagulant Therapy|journal=Stroke|volume=37|issue=1|year=2006|pages=256–262|issn=0039-2499|doi=10.1161/01.STR.0000196989.09900.f8}}</ref><ref name="GoldsteinThomas2006">{{cite journal|last1=Goldstein|first1=Joshua N.|last2=Thomas|first2=Stephen H.|last3=Frontiero|first3=Virginia|last4=Joseph|first4=Annelise|last5=Engel|first5=Chana|last6=Snider|first6=Ryan|last7=Smith|first7=Eric E.|last8=Greenberg|first8=Stephen M.|last9=Rosand|first9=Jonathan|title=Timing of Fresh Frozen Plasma Administration and Rapid Correction of Coagulopathy in Warfarin-Related Intracerebral Hemorrhage|journal=Stroke|volume=37|issue=1|year=2006|pages=151–155|issn=0039-2499|doi=10.1161/01.STR.0000195047.21562.23}}</ref><ref name="HollandWarkentin2009">{{cite journal|last1=Holland|first1=Lorne|last2=Warkentin|first2=Theodore E.|last3=Refaai|first3=Majed|last4=Crowther|first4=Mark A.|last5=Johnston|first5=Marilyn A.|last6=Sarode|first6=Ravindra|title=Suboptimal effect of a three-factor prothrombin complex concentrate (Profilnine-SD) in correcting supratherapeutic international normalized ratio due to warfarin overdose|journal=Transfusion|volume=49|issue=6|year=2009|pages=1171–1177|issn=00411132|doi=10.1111/j.1537-2995.2008.02080.x}}</ref> | * The following agents can be used for [[warfarin]] reversal:<ref name="SteinerRosand2006">{{cite journal|last1=Steiner|first1=Thorsten|last2=Rosand|first2=Jonathan|last3=Diringer|first3=Michael|title=Intracerebral Hemorrhage Associated With Oral Anticoagulant Therapy|journal=Stroke|volume=37|issue=1|year=2006|pages=256–262|issn=0039-2499|doi=10.1161/01.STR.0000196989.09900.f8}}</ref><ref name="GoldsteinThomas2006">{{cite journal|last1=Goldstein|first1=Joshua N.|last2=Thomas|first2=Stephen H.|last3=Frontiero|first3=Virginia|last4=Joseph|first4=Annelise|last5=Engel|first5=Chana|last6=Snider|first6=Ryan|last7=Smith|first7=Eric E.|last8=Greenberg|first8=Stephen M.|last9=Rosand|first9=Jonathan|title=Timing of Fresh Frozen Plasma Administration and Rapid Correction of Coagulopathy in Warfarin-Related Intracerebral Hemorrhage|journal=Stroke|volume=37|issue=1|year=2006|pages=151–155|issn=0039-2499|doi=10.1161/01.STR.0000195047.21562.23}}</ref><ref name="HollandWarkentin2009">{{cite journal|last1=Holland|first1=Lorne|last2=Warkentin|first2=Theodore E.|last3=Refaai|first3=Majed|last4=Crowther|first4=Mark A.|last5=Johnston|first5=Marilyn A.|last6=Sarode|first6=Ravindra|title=Suboptimal effect of a three-factor prothrombin complex concentrate (Profilnine-SD) in correcting supratherapeutic international normalized ratio due to warfarin overdose|journal=Transfusion|volume=49|issue=6|year=2009|pages=1171–1177|issn=00411132|doi=10.1111/j.1537-2995.2008.02080.x}}</ref> | ||
**Fresh Frozen Plasma (FFP) | **[[Fresh frozen plasma|Fresh Frozen Plasma]] ([[FFP]]) | ||
**Prothrombin Complex Concentrates (PCCs) | **[[PCC|Prothrombin Complex Concentrates]] ([[PCC|PCCs]]) | ||
* Protamine sulfate is another agent that can be used for heparin-induced Intracranial hemorrhage.<ref name="HolstLindblad1994">{{cite journal|last1=Holst|first1=J|last2=Lindblad|first2=B|last3=Bergqvist|first3=D|last4=Garre|first4=K|last5=Nielsen|first5=H|last6=Hedner|first6=U|last7=Østergaard|first7=P B|title=Protamine neutralization of intravenous and subcutaneous low-molecular-weight heparin (tinzaparin, Logiparin™). An experimental investigation in healthy volunteers|journal=Blood Coagulation & Fibrinolysis|volume=5|issue=5|year=1994|pages=795–803|issn=0957-5235|doi=10.1097/00001721-199410000-00018}}</ref> | *[[Protamine sulfate]] is another agent that can be used for [[heparin]]-induced Intracranial hemorrhage.<ref name="HolstLindblad1994">{{cite journal|last1=Holst|first1=J|last2=Lindblad|first2=B|last3=Bergqvist|first3=D|last4=Garre|first4=K|last5=Nielsen|first5=H|last6=Hedner|first6=U|last7=Østergaard|first7=P B|title=Protamine neutralization of intravenous and subcutaneous low-molecular-weight heparin (tinzaparin, Logiparin™). An experimental investigation in healthy volunteers|journal=Blood Coagulation & Fibrinolysis|volume=5|issue=5|year=1994|pages=795–803|issn=0957-5235|doi=10.1097/00001721-199410000-00018}}</ref> | ||
===== | Other measures that should be taken into account while managing a patient with intracranial hemorrhage include: | ||
* Management of [[intracranial pressure]] | |||
* Management of [[seizure]] | |||
*[[Airway management|Management of airway]] | |||
=== Management of Airway === | |||
=== Management of Intracranial Pressure === | |||
=== Management of Seizure === | |||
==References== | ==References== | ||
Latest revision as of 18:38, 18 June 2020
|
Intracranial hemorrhage Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2]
Overview
Pharmacologic therapy in patients with intracranial hemorrhage includes the administration of agents to reverse the underlying coagulopathies. Other measures that should be taken into account while managing patients with intracranial hemorrhage include the management of airway, intracranial pressure, and seizure.
Medical Therapy
Pharmacologic therapy in patients with intracranial hemorrhage include:[1]
- Hemostatic therapy to correct the underlying coagulopathies. Agents that can be used to achieve this goal may differ based on the oral anticoagulant agent which resulted in the bleeding complications.
- The following agents can be used for warfarin reversal:[2][3][4]
- Protamine sulfate is another agent that can be used for heparin-induced Intracranial hemorrhage.[5]
Other measures that should be taken into account while managing a patient with intracranial hemorrhage include:
- Management of intracranial pressure
- Management of seizure
- Management of airway
Management of Airway
Management of Intracranial Pressure
Management of Seizure
References
- ↑ Caceres, J. Alfredo; Goldstein, Joshua N. (2012). "Intracranial Hemorrhage". Emergency Medicine Clinics of North America. 30 (3): 771–794. doi:10.1016/j.emc.2012.06.003. ISSN 0733-8627.
- ↑ Steiner, Thorsten; Rosand, Jonathan; Diringer, Michael (2006). "Intracerebral Hemorrhage Associated With Oral Anticoagulant Therapy". Stroke. 37 (1): 256–262. doi:10.1161/01.STR.0000196989.09900.f8. ISSN 0039-2499.
- ↑ Goldstein, Joshua N.; Thomas, Stephen H.; Frontiero, Virginia; Joseph, Annelise; Engel, Chana; Snider, Ryan; Smith, Eric E.; Greenberg, Stephen M.; Rosand, Jonathan (2006). "Timing of Fresh Frozen Plasma Administration and Rapid Correction of Coagulopathy in Warfarin-Related Intracerebral Hemorrhage". Stroke. 37 (1): 151–155. doi:10.1161/01.STR.0000195047.21562.23. ISSN 0039-2499.
- ↑ Holland, Lorne; Warkentin, Theodore E.; Refaai, Majed; Crowther, Mark A.; Johnston, Marilyn A.; Sarode, Ravindra (2009). "Suboptimal effect of a three-factor prothrombin complex concentrate (Profilnine-SD) in correcting supratherapeutic international normalized ratio due to warfarin overdose". Transfusion. 49 (6): 1171–1177. doi:10.1111/j.1537-2995.2008.02080.x. ISSN 0041-1132.
- ↑ Holst, J; Lindblad, B; Bergqvist, D; Garre, K; Nielsen, H; Hedner, U; Østergaard, P B (1994). "Protamine neutralization of intravenous and subcutaneous low-molecular-weight heparin (tinzaparin, Logiparin™). An experimental investigation in healthy volunteers". Blood Coagulation & Fibrinolysis. 5 (5): 795–803. doi:10.1097/00001721-199410000-00018. ISSN 0957-5235.