INTRODUCTION
Intracerebral hemorrhage (ICH) occurs in approximately 10% of patients who experience a stroke. Patients in this group are typically younger and have a higher mortality rate than patients with ischemic stroke. While those with ICH typically present with changes in consciousness levels and with headache, a CT scan can assist clinicians in distinguishing an ICH stroke from an ischemic stroke. Recent trials have clarified the role of currently accepted medical therapies, including the routine administration of prophylactic anticonvulsants, management and optimization of blood pressure and mean arterial pressure control, glycemic control, and the role of osmotic diuretics in patients with increased intracranial pressure (ICP). Neurosurgical or neurological consultation is often indicated, with consideration given to invasive ICP monitoring and further imaging.

No effective targeted therapy currently exists for hemorrhagic stroke. Some preliminary research indicates that treatment with hemostatic therapy, such as administration of recombinant factor Vlla (rFVlla), could significantly reduce the mortality rate from ICH stroke by limiting bleeding in the brain.

eMedicine is pleased to offer these user-friendly, case-based CME activities covering ICH treatment modalities, medication safety and tolerability, and emerging ICH therapies. Each activity provides a maximum of 1 AMA PRA Category 1 Credit™.

Please note that these courses are accredited only for physicians (MD, DO, or equivalent). All other participants will receive a noncredit certificate of participation.

AVAILABLE COURSES

A 70-Year-Old Woman With Sudden Headache and Left-Sided Weakness
DESCRIPTION Betty L––, a 70-year-old white woman, is brought to the ED by ambulance because of a sudden onset of headache and left-sided weakness while having lunch with her husband. Betty’s husband tells EMS personnel that her headache came on suddenly, along with nausea and vomiting. Betty has difficulty moving her left arm and left leg, and she has a facial droop.

A 60-Year-Old Man With Headache and Slurred Speech
DESCRIPTION Thomas B–– is a 60-year-old white man who presents to the ED because of sudden onset of right arm weakness and difficulty speaking. He had no symptoms until 2 hours ago, when he developed a headache. By the time Thomas arrives in the ED, his right-sided weakness has worsened significantly.