Intracranial hemorrhage medical therapy

Intracranial hemorrhage Microchapters

Patient Information

Overview

Classification

Subdural hematoma
Epidural hematoma
Subarachnoid hemorrhage
Intraventricular hemorrhage
Intraparenchymal hemorrhage

Causes

Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:  Sahar Memar Montazerin, M.D.[2]

## Overview

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Pharmacologic therapy in patients with intracranial hemorrhage includes the administration of agents to reverse the underlying coagulopathies. Other measures that should be taken into account while managing patients with intracranial hemorrhage include the management of airway, intracranial pressure, and seizure.

## Medical Therapy

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Pharmacologic therapy in patients with intracranial hemorrhage include:[1]

* Hemostatic therapy to correct the underlying coagulopathies. Agents that can be used to achieve this goal may differ based on the oral anticoagulant agent which resulted in the bleeding complications.
* The following agents can be used for warfarin reversal:[2][3][4]
* Fresh Frozen Plasma (FFP)
* Prothrombin Complex Concentrates (PCCs)
* Protamine sulfate is another agent that can be used for heparin-induced Intracranial hemorrhage.[5]

Other measures that should be taken into account while managing a patient with intracranial hemorrhage include:

* Management of intracranial pressure
* Management of seizure
* Management of airway

### Management of Airway

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### Management of Intracranial Pressure

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### Management of Seizure

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## References

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1. ↑ Caceres, J. Alfredo; Goldstein, Joshua N. (2012). "Intracranial Hemorrhage". Emergency Medicine Clinics of North America. 30 (3): 771–794. doi:10.1016/j.emc.2012.06.003. ISSN 0733-8627.
2. ↑ Steiner, Thorsten; Rosand, Jonathan; Diringer, Michael (2006). "Intracerebral Hemorrhage Associated With Oral Anticoagulant Therapy". Stroke. 37 (1): 256–262. doi:10.1161/01.STR.0000196989.09900.f8. ISSN 0039-2499.
3. ↑ Goldstein, Joshua N.; Thomas, Stephen H.; Frontiero, Virginia; Joseph, Annelise; Engel, Chana; Snider, Ryan; Smith, Eric E.; Greenberg, Stephen M.; Rosand, Jonathan (2006). "Timing of Fresh Frozen Plasma Administration and Rapid Correction of Coagulopathy in Warfarin-Related Intracerebral Hemorrhage". Stroke. 37 (1): 151–155. doi:10.1161/01.STR.0000195047.21562.23. ISSN 0039-2499.
4. ↑ Holland, Lorne; Warkentin, Theodore E.; Refaai, Majed; Crowther, Mark A.; Johnston, Marilyn A.; Sarode, Ravindra (2009). "Suboptimal effect of a three-factor prothrombin complex concentrate (Profilnine-SD) in correcting supratherapeutic international normalized ratio due to warfarin overdose". Transfusion. 49 (6): 1171–1177. doi:10.1111/j.1537-2995.2008.02080.x. ISSN 0041-1132.
5. ↑ Holst, J; Lindblad, B; Bergqvist, D; Garre, K; Nielsen, H; Hedner, U; Østergaard, P B (1994). "Protamine neutralization of intravenous and subcutaneous low-molecular-weight heparin (tinzaparin, Logiparin™). An experimental investigation in healthy volunteers". Blood Coagulation & Fibrinolysis. 5 (5): 795–803. doi:10.1097/00001721-199410000-00018. ISSN 0957-5235.

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