ICH A&P Note

**Symptom - **Localization - **Vascular Teritory Vs Cause (Aneurysm Vs HTN)

Hemorrhagic Stroke:

- Admit to ICU (Vitals Q1)

- Telemetry

- BP Monitoring

- Neuro Checks Q1 Hour

- Keep MAP < 110

(Use Hydralazine 10 mg, Labetolol 10 mg IV Q30 mins

(May Start Nicardipine Gtt 5mg/hr max dose 15mg/hr)

- Repeat CT Scan after 24 Hours

- Neurovascular Evaluation: CTA Head and Neck for vascular abnomality and aneurysm

- ESR, CRP, HbA1c, Lipid Panel, UA, UDS

- If Acute Change in Mental Status; STAT CT Brain

History of Platelet Inhibitor use in presence clinically sig brain bleed:

- Hold all anti-platelets

- Platelet Mapping

- Will consider platelet transfusion

Anticoagulation use per History:

- Warfarin/dabigatran/abxicban

- Given *** Units of FFP

- Given *** Units of Vit K

- Transfuse *** Units of FFP

- Patient is a great chance of hematoma expansion.

- Low threshold to get CT Brain in any change of exam

***Seizure Prophylaxis:(if Cortical)

- Keppra 500 mg PO BID for 7 Days

FEN

- Bedside Swallow Eval

DVT Prophylaxis

- Hold SubQ Heparin

- SCDs