Translating Knowledge into Practice in Hemorrhagic Stroke - The Cutting Edge of ICH Care

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According to the Centers for Disease Control and Prevention (CDC), more than 795,000 people have a stroke each year in the United States. Every 4 minutes, an individual dies from a stroke. The financial impact of strokes on the healthcare system is staggering, with an estimated $34 billion spent annually in the US, which includes the cost of healthcare services, medicines to treat stroke patients, and lost productivity. Although hemorrhagic strokes comprise only 13% of all strokes, they are particularly costly from both a clinical and financial perspective.

Oral anticoagulants increase a patient’s risk of major bleeding events, especially intracerebral hemorrhages. In anticoagulated patients, distinguishing major from minor bleeding and appropriately employing emergent options to manage major bleeding are imperative. Clinicians must be familiar with the risks associated with anticoagulant use, as well as the management approaches to patients with oral anticoagulant-associated intracerebral hemorrhage. Nationally recognized guidelines have provided direction on how to utilize repletion and reversal strategies to manage these types of major bleeding events. 

Educational resources presented by experts from Comprehensive & Primary Stroke Centers and Level 1 Emergency Departments can provide additional guidance for healthcare professionals regarding the presentation and pathophysiology of different types of strokes, the most effective use of imaging modalities for evaluating patients with stroke, and management approaches to patients with stroke, particularly those with oral anticoagulant-associated hemorrhagic stroke.

  • Standardizing the Diagnostic Workup for Hemorrhagic Strokes – What Is Left To Do?

  • What Resources Are Necessary To Optimize Care For the Anticoagulated Hemorrhagic Stroke Patient?

  • The Future of Imaging in ICH: What is Next?

  • Case Review: Imaging Strategies and Interpretation in Hemorrhagic Stroke – What Does Every Provider Need To Know?

  • Prevention of Rebleeding in ICH – What Goes Right, What Goes Wrong: Comparing Two Cases

  • Assessing the Critical Hemorrhage Patient – Intracranial, Intraspinal, and Intraocular Bleeding in the ED

  • When To Consider Immediate Transfer of a Patient Without Intervention: Are There Times When No Reversal Is Better Than Some Reversal?

Faculty:

Chris Droege, PharmD, BCCCP, FCCM, FASHP
Clinical Pharmacy Specialist, Critical Care
UC Health – University of Cincinnati Medical Center
Cincinnati, OH

Brandon Foreman, MD, MS, FACNS, FNCS
Associate Professor of Neurology & Rehabilitation Medicine
Associate Director for Neurocritical Care Research
Director, Neuroinformatics Lab
University of Cincinnati Gardner Neuroscience Institute, Cincinnati, OH

Aaron W. Grossman, MD, PhD
Vascular and Interventional Neurology
Co-Director, Comprehensive Stroke Center
Depts of Neurology and Neurosurgery
University of Cincinnati, Cincinnati, OH

Charles Kircher, MD, FAHA
Assistant Professor of Emergency Medicine
University of Cincinnati College of Medicine
Neurointensivist, Gardner Neuroscience Institute
Co-Director, UC Stroke Team, Cincinnati, OH

Matthew Smith, MD
Neurocritical Care
Endovascular Neurosurgery Fellow
University of Cincinnati, Cincinnati, OH

Kyle B. Walsh, MD, MS
Associate Professor
Department of Emergency Medicine
Stroke Team and Division of Neurocritical Care
University of Cincinnati, Cincinnati, OH