Intracerebral hemorrhage history and symptoms: Difference between revisions

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==Overview==
==Overview==
It is critical to obtain a detailed and focused history in patient with intracerebral hemorrhage. History of gradual onset of symptoms, [[Vomiting]], [[hypertension]], [[lipid disorders]], smoking, [[Antiplatelet drug|antiplatlete]]/[[Anticoagulant therapy|anticoagulation medication]], or illicit drug use, [[dementia]], [[Liver Diseases|liver]], and [[chronic kidney disease]] may suggest intracerebral hemorrhage as one of the initial differential diagnosis..<ref name="Huhtakangas" /><ref name="Rådberg" /><ref name="Flaherty" /><ref name="pmid12843354" /><ref name="pmid11346811" /><ref name="pmid4105427" />


==History==
==History==
It is critical to obtain a detailed and focused history.<ref name=Huhtakangas>Huhtakangas J, Tetri S, Juvela S, Saloheimo P, Bode MK, Hillbom M. Effect of increased warfarin use on warfarin-related cerebral hemor- rhage: a longitudinal population-based study. Stroke. 2011;42:2431– 2435. doi: 10.1161/STROKEAHA.111.615260.</ref><ref name=Rådberg> Rådberg JA, Olsson JE, Rådberg CT. Prognostic parameters in sponta- neous intracerebral hematomas with special reference to anticoagulant treatment. Stroke. 1991;22:571–576. doi: 10.1161/01.STR.22.5.571.</ref><ref name=Flaherty> Flaherty ML, Kissela B, Woo D, Kleindorfer D, Alwell K, Sekar P, Moomaw CJ, Haverbusch M, Broderick JP. The increasing incidence of anticoagulant-associated intracerebral hemorrhage. Neurology. 2007;68:116–121. doi: 10.1212/01.wnl.0000250340.05202.8b.</ref><ref name="pmid12843354">{{cite journal| author=Ariesen MJ, Claus SP, Rinkel GJ, Algra A| title=Risk factors for intracerebral hemorrhage in the general population: a systematic review. | journal=Stroke | year= 2003 | volume= 34 | issue= 8 | pages= 2060-5 | pmid=12843354 | doi=10.1161/01.STR.0000080678.09344.8D | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12843354  }} </ref><ref name="pmid17962600">{{cite journal| author=Bos MJ, Koudstaal PJ, Hofman A, Breteler MM| title=Decreased glomerular filtration rate is a risk factor for hemorrhagic but not for ischemic stroke: the Rotterdam Study. | journal=Stroke | year= 2007 | volume= 38 | issue= 12 | pages= 3127-32 | pmid=17962600 | doi=10.1161/STROKEAHA.107.489807 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17962600  }} </ref><ref name="pmid23077009">{{cite journal| author=Hackam DG, Mrkobrada M| title=Selective serotonin reuptake inhibitors and brain hemorrhage: a meta-analysis. | journal=Neurology | year= 2012 | volume= 79 | issue= 18 | pages= 1862-5 | pmid=23077009 | doi=10.1212/WNL.0b013e318271f848 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23077009  }}  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23449782 Review in: Evid Based Ment Health. 2013 May;16(2):54] </ref>
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|+
! style="background: #4479BA; width: 220px;" | {{fontcolor|#FFF|History}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Comments}}
|-
| style="padding: 5px 5px; background: #DCDCDC;" |'''Timing of the symptoms onset'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*The time the patient was last normal
|-
| style="padding: 5px 5px; background: #DCDCDC;" |'''Initial symptoms'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*The progression of symptoms
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Vascular risk factors'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*History of [[hypertension]]
*History of [[hypocholesterolemia]]
*[[Smoking]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" |'''Medications'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Anticoagulants]]
*[[Antiplatelet agents]]
*[[Decongestants]]
*Antihypertensive medications
*[[Stimulants]] (including diet pills)
*[[Sympathomimetics]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Recent trauma or surgery'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*ICH may be related to hyperperfusion after
**[[endarterectomy |Carotid endarterectomy]]
**[[stenting |Carotid stenting]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Dementia'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Associated with [[amyloid|amyloid angiopathy]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Alcohol or illicit drug use'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*[[Cocaine]]
*Other sympathomimetic drugs
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Liver disease
| style="padding: 5px 5px; background: #F5F5F5;" |
*Associated with [[coagulopathy]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Chronic kidney disease
| style="padding: 5px 5px; background: #F5F5F5;" |
*Associated with p[[latelet dysfunction]]
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''Cancer and hematologic disorders
| style="padding: 5px 5px; background: #F5F5F5;" |
*Associated with [[coagulopathy]]
|}


==Symptoms==
==Symptoms==
Non specific symptoms of intracerebral hemorrhage may include:<ref name="pmid11346811">{{cite journal| author=Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF| title=Spontaneous intracerebral hemorrhage. | journal=N Engl J Med | year= 2001 | volume= 344 | issue= 19 | pages= 1450-60 | pmid=11346811 | doi=10.1056/NEJM200105103441907 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11346811  }} </ref><ref name="pmid4105427">{{cite journal| author=Fisher CM| title=Pathological observations in hypertensive cerebral hemorrhage. | journal=J Neuropathol Exp Neurol | year= 1971 | volume= 30 | issue= 3 | pages= 536-50 | pmid=4105427 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4105427  }} </ref>
*Gradual onset of symptoms (unlike SAH the symptoms are not maximal at onset)
*[[Vomiting]]
*[[Systolic blood pressure]] >220 mm Hg
*[[headache|Severe headache]]
*[[loss of consciousness|Decreased level of consciousness]]


==References==
==References==

Latest revision as of 01:30, 4 December 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]

Overview

It is critical to obtain a detailed and focused history in patient with intracerebral hemorrhage. History of gradual onset of symptoms, Vomiting, hypertension, lipid disorders, smoking, antiplatlete/anticoagulation medication, or illicit drug use, dementia, liver, and chronic kidney disease may suggest intracerebral hemorrhage as one of the initial differential diagnosis..[1][2][3][4][5][6]

History

It is critical to obtain a detailed and focused history.[1][2][3][4][7][8]

History Comments
Timing of the symptoms onset
  • The time the patient was last normal
Initial symptoms
  • The progression of symptoms
Vascular risk factors
Medications
Recent trauma or surgery
Dementia
Alcohol or illicit drug use
  • Cocaine
  • Other sympathomimetic drugs
Liver disease
Chronic kidney disease
Cancer and hematologic disorders

Symptoms

Non specific symptoms of intracerebral hemorrhage may include:[5][6]

References

  1. ↑ 1.0 1.1 Huhtakangas J, Tetri S, Juvela S, Saloheimo P, Bode MK, Hillbom M. Effect of increased warfarin use on warfarin-related cerebral hemor- rhage: a longitudinal population-based study. Stroke. 2011;42:2431– 2435. doi: 10.1161/STROKEAHA.111.615260.
  2. ↑ 2.0 2.1 Rådberg JA, Olsson JE, Rådberg CT. Prognostic parameters in sponta- neous intracerebral hematomas with special reference to anticoagulant treatment. Stroke. 1991;22:571–576. doi: 10.1161/01.STR.22.5.571.
  3. ↑ 3.0 3.1 Flaherty ML, Kissela B, Woo D, Kleindorfer D, Alwell K, Sekar P, Moomaw CJ, Haverbusch M, Broderick JP. The increasing incidence of anticoagulant-associated intracerebral hemorrhage. Neurology. 2007;68:116–121. doi: 10.1212/01.wnl.0000250340.05202.8b.
  4. ↑ 4.0 4.1 Ariesen MJ, Claus SP, Rinkel GJ, Algra A (2003). "Risk factors for intracerebral hemorrhage in the general population: a systematic review". Stroke. 34 (8): 2060–5. doi:10.1161/01.STR.0000080678.09344.8D. PMID 12843354.
  5. ↑ 5.0 5.1 Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF (2001). "Spontaneous intracerebral hemorrhage". N Engl J Med. 344 (19): 1450–60. doi:10.1056/NEJM200105103441907. PMID 11346811.
  6. ↑ 6.0 6.1 Fisher CM (1971). "Pathological observations in hypertensive cerebral hemorrhage". J Neuropathol Exp Neurol. 30 (3): 536–50. PMID 4105427.
  7. ↑ Bos MJ, Koudstaal PJ, Hofman A, Breteler MM (2007). "Decreased glomerular filtration rate is a risk factor for hemorrhagic but not for ischemic stroke: the Rotterdam Study". Stroke. 38 (12): 3127–32. doi:10.1161/STROKEAHA.107.489807. PMID 17962600.
  8. ↑ Hackam DG, Mrkobrada M (2012). "Selective serotonin reuptake inhibitors and brain hemorrhage: a meta-analysis". Neurology. 79 (18): 1862–5. doi:10.1212/WNL.0b013e318271f848. PMID 23077009. Review in: Evid Based Ment Health. 2013 May;16(2):54


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