Assist Lect Shaymaa Hasan Abbas DESIRED TREATMENT OUTCOMES The shortterm goals for the treatment of hemorrhagic stroke include rapid neurointensive care treatment to maintain adequate oxygenation breathing and circulation Management of increased intracranial pressure and blood pr ID: 927407
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Slide1
HEMORRHAGIC STROKE
DONE BY
Assist. Lect.
Shaymaa
Hasan
Abbas
Slide2DESIRED TREATMENT OUTCOMES
The short-term goals for the treatment of hemorrhagic stroke include rapid
neurointensive
care treatment to maintain adequate oxygenation, breathing, and circulation. Management of increased intracranial pressure and blood pressure (BP) are important in the acute setting.
Slide3DESIRED TREATMENT OUTCOMES
Long-term management includes prevention of complications and prevention of a recurrent bleed and delayed cerebral ischemia. Prevention of long-term disability and death related to them stroke are important regardless of the type of stroke.
Slide4TREATMENT
OF
ACUTE HEMORRHAGIC STROKE
There is no proven treatment for
intracerebral
hemorrhage. Management is based on
neurointensive
care treatment and prevention of complications. Treatment should be provided to manage the needs of the critically ill patient including management of increased intracranial pressure, seizures, infections, and prevention of re-bleeding and delayed cerebral ischemia
Slide5TREATMENT OF ACUTE HEMORRHAGIC STROKE
Blood pressure is often elevated after hemorrhagic stroke and appropriate management is important to prevent re-bleeding and expansion of the hematoma. Blood pressure can be controlled with IV boluses of labetalol 10 to 80 mg every 10 minutes up to a maximum of 300 mg or with IV infusions of labetalol (0.5 to 2 mg/minute) or
nicardipine
(5 to 15 mg/hour).
Slide6TREATMENT OF ACUTE HEMORRHAGIC STROKE
Deep vein thrombosis prophylaxis with intermittent compression stockings should be implemented early after admission.
Slide7TREATMENT OF ACUTE HEMORRHAGIC STROKE
Oral
nimodipine
is recommended in subarachnoid hemorrhage to prevent delayed cerebral ischemia. Delayed cerebral ischemia occurs 4 to 14 days after the initial aneurysm rupture and is a common cause of neurologic deficits and death.
Slide8TREATMENT OF ACUTE HEMORRHAGIC STROKE
Hemostatic Therapy: Recombinant factor
VIIa
has been shown to have a benefit in the treatment of ICH.
Slide9THANK YOU