Spontaneous intracerebral hemorrhage checklist [Neurosurgery Wiki]

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====== Spontaneous intracerebral hemorrhage checklist ======

The following check-list is presented to assist in gathering historical information important in evaluating & managing the adult with spontaneous ICH (modified):

1. time course of symptoms: time of initial onset (or when last seen normal)

2. initial symptoms and progression

3. seizure

4. hypertension history

5. drugs:

a) sympathomimetics:

● amphetamines, cocaine

● appetite suppressants or nasal decongestants (pseudoephedrine)

b) dietary supplements:especially ephedra alkaloids(mahuang)

c) anticoagulants: warfarin (Coumadin®), dabigatran (Pradaxa®), apixaban (Eliquis®)...

d) antiplatelet drugs:aspirin (patients often forget taking low dose 81mg),Plavix,NSAIDS

e) oral contraceptive(birth control pills):questionable association

f) history of alcohol abuse

6. past medical history 

a) coagulopathies

b) history of dementia:ICH may be associated with cerebral amyloid angiopathy

c) liver disease: may be associated with coagulopathy

d) previous stroke

e) history of known vascular abnormalities(AVM,venous angioma...)

f) tumor: known history of cancer, especially those that tend to go to brain (lung, breast, GI,
renal, melanoma...) or associated with coagulopathy (leukemia)

7. recent surgery: especially carotid stenting or endarterectomy, procedures requiring heparin...

8. recent childbirth and/or eclampsia or preeclampsia

9. history of recent trauma