Hemorrhagic Stroke

Description:

This book provides detailed practical guidance on the management of hemorrhagic stroke in the clinical settings encountered in daily practice. Real-life cases are used to depict a wide range of clinical scenarios and to highlight significant aspects of management of hemorrhagic stroke. In addition, diagnostic and therapeutic protocols are presented and helpful decision-making algorithms are provided that are specific to the different professionals involved in delivery of stroke care and to differing types of hospital facility. The coverage is completed by the inclusion of up-to-date scientific background information relevant to diagnosis and therapy. Throughout, the approach adopted is both practical and multidisciplinary. The book will be of value for all practitioners involved in the provision of stroke care, and also for medical students.

Table of Contents:

Chapter 1: Diagnosis and Therapy in the Acute Phase of Hemorrhagic Stroke: Latest Developments

1.1 Intraparenchymal Brain Hemorrhage

1.1.1 Epidemiology

1.1.2 Aetiology

Cerebral Amyloid Angiopathy (CAA)

Secondary causes of ICH are as follows:

Location

1.1.3 Prognosis

Prognostic Factors

Hematoma Volume

Intraventricular Bleeding in ICH

Peri-hemorrhagic Oedema

Statins

1.1.4 Diagnosis

Clinical Presentation

Instrumental Diagnosis

Blood Tests

1.1.5 Treatment of the Acute Phase

Medical Treatment

Blood Pressure Treatment

Acute Haemostatic Treatment

Coagulation Treatment in Secondary ICH After Anticoagulation Therapy

Surgical Treatment

Vascular Disorders in Need of Neurosurgical Expertise

Spontaneous Intraparenchymal Hematoma

Cerebral Aneurysm

Arteriovenous Malformations (AVMs)

Endovascular Treatment of Arteriovenous Malformations (AVMs) with Cerebral Hemorrhage

Cavernous Angioma

Dural Arteriovenous Fistulas (DAVFs)

Endovascular Treatment of Dural Arteriovenous Fistulas (DAVFs) with Cerebral Hemorrhage

1.1.6 Complications

Seizures

Fever

Treatment of Hypoglycaemia

Deep Vein Thrombosis (DVT)

Indications for Monitoring Intracranial Pressure (ICP) in Hemorrhagic Stroke

1.2 Subarachnoid Hemorrhage

1.2.1 Epidemiology

1.2.2 Aetiology

1.2.3 Risk Factors

1.2.4 Prognosis

Perimesencephalic Nonaneurysmal Hemorrhage

1.2.5 Clinical Presentation

1.2.6 Acute-Phase Management

1.2.7 Assessment in Emergency

1.2.8 Instrumental Diagnostics

Identifying Location of the Bleed

1.2.9 Rating Scales

1.2.10 Treatment of the Acute Phase and Complications

Re-bleeding

Aneurysm Treatment

Endovascular Treatment of Aneurysms in Emergency

Surgical Treatment

Medical Treatment of Re-bleeding

Delayed Cerebral Ischemia (DCI)

DCI Monitoring

Clinical Monitoring

Instrumental Monitoring

Monitoring of Delayed Cerebral Ischemia

Medical Therapy

Endovascular Treatment of Vasospasm Resulting from Subarachnoid Hemorrhage

Other Complications of SAH

Seizures

Fever

Cardiovascular Complications

Hyponatraemia

1.3 Appendix

1.3.1 ICH Score [36]

1.3.2 Evaluation Scales

Glasgow Coma Scale (GCS)

References

Chapter 2: Clinical Cases Elio Agostoni, Edoardo Boccardi, Marco Cenzato, and Marco Longoni

2.1 Case Study No. 1

2.2 Case Study No. 2

2.3 Case Study No. 3

2.4 Case Study No. 4

2.5 Case Study No. 5

2.6 Case Study No. 6

2.7 Case Study No. 7

2.8 Case Study No. 8

2.9 Case Study No. 9

2.10 Case Study No. 10

2.11 Case Study No. 11

References

Chapter 3: Clinical Organizational Pathways for Hemorrhagic Stroke

3.1 Management

3.1.1 Prehospital Management

3.1.2 In-Hospital Management

3.2 Medical Treatment

3.2.1 Hemostasis and Coagulation

3.2.2 Controlling Hypertension

3.2.3 Managing Glycemia

3.2.4 Managing Body Temperature

3.2.5 Treating Epileptic Seizures

3.2.6 Managing Medical Complications

3.2.7 Monitoring and Managing Intracranial Hypertension

3.3 Surgical Treatment

3.3.1 Intraventricular Hemorrhage

3.3.2 Surgical Treatment of Cerebral Hemorrhage

3.4 Secondary Prevention

3.4.1 Control of Hypertension

3.4.2 Management of Anticoagulation and Antiplatelet Treatments

3.5 Subarachnoid Hemorrhage

3.5.1 Initial Evaluation

3.5.2 Diagnosis

3.5.3 Medical Management

3.5.4 Treatment of Aneurysms

3.5.5 Management of Hydrocephalus

3.5.6 Prevention of Vasospasm

References

Chapter 4: Differentiated Decisional Algorithms