Hemorrhagic stroke

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AHA Guidlines

  1. Keep MAP <130 during acute phase
  2. When patient is anticoagulated on warfarin with INR > 2.0 should consider reversal with following:
    1. Vitamin K 10mg IV (small risk of anaphylaxis, takes up to 6 hours to work)
  3. FFP (generally need up to 6 units to bring INR to 1.2; careful about volume overload in the elderly)
  4. Prothrombin Complex Concentrate (25-50mg/kg IV)
    1. very expensive with limited data but trends are moving towards using this in life threatening bleeding. can decrease hematoma expansion.
  5. Desmopressin: can increase activity of platelets via vWF

Source

Arabinda Pani, MD

2/20/2010