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/

Avsnitt(1149)

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Author: Aaron Lessen, M.D. Educational Pearls 2 studies this past year looked at pediatric and adolescent patients following a concussion. They found people who returned to activity sooner did better...

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Podcast #227: CPR-Induced Consciousness

Author: Nick Hatch, M.D. Educational Pearls CPR-induced consciousness is a phenomenon that occurs when someone who was previously unconscious and is undergoing CPR regains consciousness and makes pur...

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Podcast #226: Biphasic Anaphylaxis

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Author: Sam Killian, M.D. Educational Pearls Anaphylaxis is common in the ED. These patients are treated and then usually watched for 4-6 hours. Biphasic happens in patients that have a complete reso...

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Author: Dylan Luyten, M.D. Educational Pearls Rhogam is commonly used when an Rh negative woman has an Rh positive fetus. It is commonly used in the ER in the setting of a miscarriage. Rh(+) fetal bl...

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Deep Dive #4: Pediatric Type I DKA

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Author: Justin Harper Justin Harper, a paramedic married to a pediatric nurse, discovered his own son had type I diabetes 2 years ago. Despite their medical experience, this diagnosis came as surprise...

14 Juli 201747min

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