Question 113 · LEK · Hemorrhagic stroke
Which of the following statements referring to a patient in the acute phase of brain hemorrhagic stroke is correct?
1) supratentorial intracerebral hematoma should be treated with surgery in each case;
2) systolic blood pressure should be quickly reduced to less than 180 mm Hg in each patient with intracerebral hemorrhage, optimally during the first day;
3) posterior fossa hemorrhages need urgent neurosurgery in the case of the deterioration of the neurological condition, such as worsening cerebellar symptoms, hydrocephalus, or awareness disorders;
4) antiepileptic drug should be administered prophylactically in each patient with intracerebral hemorrhage (optimally valproic acid 500-800 mg twice daily) for fear of high risk of epileptic seizures;
5) in the treatment of cerebral oedema secondary to intracerebral hemorrhage intravenous osmotic agents are most commonly used, e.g. mannitol with furosemide or hypertonic salt (usually 3% NaCl).
The correct answer is:
2) systolic blood pressure should be quickly reduced to less than 180 mm Hg in each patient with intracerebral hemorrhage, optimally during the first day;
3) posterior fossa hemorrhages need urgent neurosurgery in the case of the deterioration of the neurological condition, such as worsening cerebellar symptoms, hydrocephalus, or awareness disorders;
4) antiepileptic drug should be administered prophylactically in each patient with intracerebral hemorrhage (optimally valproic acid 500-800 mg twice daily) for fear of high risk of epileptic seizures;
5) in the treatment of cerebral oedema secondary to intracerebral hemorrhage intravenous osmotic agents are most commonly used, e.g. mannitol with furosemide or hypertonic salt (usually 3% NaCl).
The correct answer is:
- A. 1,3,5.
- B. 1,3,4.
- C. 2,3,5.
- D. 2,3,4.
- E. all the above.
Hint
Be wary of absolute wording such as 'in each case' and recall which ICH patients really benefit from surgery or seizure prophylaxis.
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