Podcast #194: Atruamatic ICH

Podcast #194: Atruamatic ICH

Author: Peter Bakes, M.D

Educational Pearls

  • Intracerebral hemorrhage is an intracranial bleed within the brain tissue or ventricles.
  • Subarachnoid aneurysm causes about 50% of all ICH.
  • Amyloid deposition can lead to ICH in elderly patients.
  • Hypertension is another common cause of atraumatic ICH, commonly leading to pontine, cerebellar, or basal ganglial bleeding. Bleeding in other locations is suggestive of a different etiology.
  • ICH will often present with depressed mental status, but specifically a patient with a systolic BP > 220 is suggestive of hypertensive ICH.
  • CT is the first diagnostic step. CTA should be considered when the bleeding is in an atypical area. Significant edema on imaging can be suggestive of a tumor.
  • Treatment should include hemostatic measures and BP control. Transfuse platelets if necessary and reverse any anticoagulation. BP target is <140 systolic. Monitor ICP if patient has AMS. Neurosurgical intervention is indicated when there is significant expansion of the hematoma with AMS or if the bleed is cerebellar.

References: Sahni R, Weinberger J. Management of intracerebral hemorrhage. Vascular Health and Risk Management. 2007;3(5):701-709. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2291314/

Episoder(1144)

Episode 973: Meningitis Retention Syndrome

Episode 973: Meningitis Retention Syndrome

Contributor: Travis Barlock MD Educational Pearls: Meningitis retention syndrome is a relatively novel and rare clinical condition Aseptic meningitis + acute urinary retention One study reports an i...

8 Sep 20252min

Episode 972: Hepatic Encephalopathy

Episode 972: Hepatic Encephalopathy

Contributor: Alec Coston, MD Educational Pearls: Hepatic encephalopathy (HE) is defined as a disruption in brain function that results from impaired liver function or portosystemic shunting. Manifes...

3 Sep 20253min

Episode 971: Calcium Pretreatment for Diltiazem in AFib with RVR

Episode 971: Calcium Pretreatment for Diltiazem in AFib with RVR

Contributor: Taylor Lynch, MD Educational Pearls: What is atrial fibrillation with rapid ventricular response (AFib with RVR) and how does it differ from atrial fibrillation (AFib)? AFib is an abnorm...

25 Aug 20252min

Episode 970: Fever Management

Episode 970: Fever Management

Contributor: Aaron Lessen, MD Educational Pearls: Recorded March 2025 What is the best treatment for a fever? Tylenol? Ibuprofen? Combined? Alternating the two? The journal Pediatrics aimed to answer...

22 Aug 20252min

Episode 969: Shoulder Reduction

Episode 969: Shoulder Reduction

Contributor: Aaron Lessen, MD Educational Pearls: There are many techniques for reducing a shoulder dislocation A recent study discussed a new variation of closed reduction technique: wrist-clamping ...

11 Aug 20252min

Episode 968: Heavy Metals

Episode 968: Heavy Metals

Contributor: Megan Hurley MD Educational Pearls: Acute toxicity of heavy metals: Gastrointestinal upset is the most common presentation Chronic toxicity of heavy metals: Symptoms depend on the meta...

4 Aug 20252min

Episode 967: Dilutional Hyponatremia

Episode 967: Dilutional Hyponatremia

Contributor: Taylor Lynch, MD Educational Pearls: Dilutional Hyponatremia: Occurs when there is an excess of free water relative to sodium in the body. Causes a falsely low sodium concentration witho...

28 Jul 20252min

EMSAC 2024

EMSAC 2024

Contributors: Col. (Dr.) Stacy Shackelford Dr. Sean Keenan Paramedic Alan Moreland Dr. Chris Tems Kara Napolitano From military-inspired trauma protocols to behavioral health alternatives and cardiac ...

26 Jul 202511min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
smart-forklart
jss
sinnsyn
rekommandert
rss-rekommandert
villmarksliv
tomprat-med-gunnar-tjomlid
forskningno
rss-paradigmepodden
fjellsportpodden
aldring-og-helse-podden
tidlose-historier
diagnose
pod-britannia
vett-og-vitenskap-med-gaute-einevoll
nordnorsk-historie
nevropodden
dekodet-2