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Wednesday, May 09, 2007

New Guidelines Issued for Intracerebral Hemorrhage - CME Teaching Brief® - MedPage Today

New Guidelines Issued for Intracerebral Hemorrhage -
"DALLAS, May 8 -- New evidence-based guidelines for treatment of intracerebral hemorrhage suggest reserving surgery for bleeds greater than 3 cm in deteriorating patients or when there is brainstem compression. Action Points

Explain to interested patients that intracerebral hemorrhage causes between 10% and 15% of first-ever strokes and has a 30-day mortality rate of between 35% and 52%.


Note that treatment options are increasing and explain that new guidelines published by the American Heart Association suggest how to employ existing choices.
The guidelines, published in the June issue of Stroke, Journal of the American Heart Association, also address, for the first time, end-of-life issues and do-not-resuscitate orders in hemorrhagic stroke. The guidelines suggest that DNR orders not be initiated within the first 24 hours after onset of a stroke.
The heart association's guidelines take into account advances in knowledge since 1999, when the first guidelines were issued, and look forward to new approaches in the next few years, according to Joseph Broderick, M.D., of the University of Cincinnati, who chaired the writing committee.
Intracerebral hemorrhage, which causes 10% to 15% of first-ever strokes, has a 30-day mortality rate of 35% to 52%, Dr. Broderick said. 'The time is right for updating the guidelines because there have been a number of published studies that may affect how we manage these very sick patients.' " /.../

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