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