Translating Knowledge into Practice in Hemorrhagic Stroke - Improving Patient Outcomes

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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 is 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.

 This program discusses:

 • The definition, identification, and pathophysiology of hemorrhagic strokes

 • The role of imaging in distinguishing different types of strokes and in identifying the etiology of hemorrhagic strokes

 • Repletion and reversal strategies for the management of hemorrhagic strokes in the anticoagulated patient

  • Defining the Types of Brain Hemorrhage: What Front-line Clinicians Should Understand

  • Understanding the Complex Pathophysiology of Hemorrhagic Stroke

  • Hemorrhagic Stroke Recognition

  • What is the Role of Imaging When Determining the Different Types of Strokes?

  • Use of Imaging in the Diagnosis of Intracerebral Hemorrhage

  • Key Repletion and Reversal Strategies for the Management of Hemorrhagic Stroke

  • A Case Review in ICH-Repletion or Reversal-Factors vs Antidotes and Overarching Strategies

  • Defining the Types of Brain Hemorrhage: What Front-line Clinicians Should Understand

  • Understanding the Complex Pathophysiology of Hemorrhagic Stroke

  • Hemorrhagic Stroke Recognition


Faculty:

Stacie L. Demel, DO, PhD
Assistant Professor, Department of Neurology and Rehabilitation Medicine
University of Cincinnati, Cincinnati, OH

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