Saudi Stroke Standards

Intracerebral Haemorrhage Purpose To ensure that immediate, appropriate assessment is carried out for hemorrhagic stroke to ensure that the patient can receive the required treatment. Rationale Approximately 15-20% percentage of total strokes are due to hemorrhage. Timely management of hemorrhagic stroke improves patient outcomes. Standards 9 Powers, W. J., Rabinstein, A. A., Ackerson, T., Adeoye, O. M., Bambakidis, N. C., Becker, K., ... & Jauch, E. C. (2018). 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 49(3), e46-e99. 10 Powers, W. J., et al., (2018). 1. All adult patients with suspected hemorrhagic stroke must have immediate assessment and investigations to establish a diagnosis, initiate treatment and determine eligibility for surgical interventions. 2. All health care facilities caring for patients with primary intracerebral hemorrhage should have an evidence-based protocol outlining blood pressure control, reversal of coagulopathy and indication for neurosurgical intervention. 3. All Patients with spontaneous bleed should be managed using standardized guidelines and protocols. 4. All Patients with intracerebral hemorrhage related to anticoagulation use should have their coagulation profile checked immediately and correction of coagulopathy should be initiated rapidly, as per the established guidelines and protocols. 5. All patient with primary intracerebral hemorrhage must have urgent access to neurological expertise when needed. 6. All patients with acute spontaneous intra-cranial hemorrhage should be admitted to a stroke unit or equivalent. QM