Complete workup for Intracranial Hemorrhage

Complete workup for Intracranial Hemorrhage

What is considered a Complete workup for Intracranial Hemorrhage? 

The urgency and possibly extent of workup will depend on the clinical scenario: an octogenarian with Alzheimer’s disease and an occipital ICH may require less etiologic workup than would a 65-year-old with a basal ganglia ICH and decades of poorly controlled hypertension.

Cases that do not fit these profiles require vessel imaging to evaluate for arteriovenous malformations (AVMs) or aneurysms and MRI with contrast to evaluate for tumors.

Aneurysm rupture can cause intraparenchymal hemorrhage, so it is important to consider SAH as well as cerebral venous sinus thrombosis (see below).

If initial workup is unrevealing, repeat studies after the hematoma has resolved (2 to 3 months) may be useful.

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