Hemorrhagic stroke risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Risk Factors

Intracerebral hemorrhage

Common risk factors in the development of intracerebral hemorrhage (ICH) include:^[1]^[2]^[3]

Anticoagulation medication
- Vitamin K antagonists (VKAs) such as warfarin
Acquired or congenital coagulation factor disorders
- Vitamin K deficiency
- Liver disease
- Disseminated Intravascular Coagulation (DIC)
- Hemophilias
Acquired qualitative or quantitative platelet abnormalities
Embolic strokes
Hypertension
Sickle Cell Anemia

New anticoagulant medications such as dabigatran, rivaroxaban, and apixaban appear to be associated with a lower risk of ICH than VKAs. ^[4]

Subarachnoid hemorrhage

Common risk factors in the development of subarachnoid hemorrhage (SAH) include:^[5]^[6]^[7]^[8]^[9]

Positive family history
Alcoholism
Hypertension
Smoking
Heavy alcohol consumption
Abnormal connective tissue
Female gender
African race
Japanese or Finnish descent

References

↑ Huhtakangas J, Tetri S, Juvela S, Saloheimo P, Bode MK, Hillbom M. Effect of increased warfarin use on warfarin-related cerebral hemor- rhage: a longitudinal population-based study. Stroke. 2011;42:2431– 2435. doi: 10.1161/STROKEAHA.111.615260.
↑ Rådberg JA, Olsson JE, Rådberg CT. Prognostic parameters in sponta- neous intracerebral hematomas with special reference to anticoagulant treatment. Stroke. 1991;22:571–576. doi: 10.1161/01.STR.22.5.571.
↑ Flaherty ML, Kissela B, Woo D, Kleindorfer D, Alwell K, Sekar P, Moomaw CJ, Haverbusch M, Broderick JP. The increasing incidence of anticoagulant-associated intracerebral hemorrhage. Neurology. 2007;68:116–121. doi: 10.1212/01.wnl.0000250340.05202.8b.
↑ Chatterjee S, Sardar P, Biondi-Zoccai G, Kumbhani DJ. New oral anticoagulants and the risk of intracranial hemorrhage: traditional and Bayesian meta-analysis and mixed treatment comparison of random- ized trials of new oral anticoagulants in atrial fibrillation. JAMA Neurol. 2013;70:1486–1490. doi: 10.1001/jamaneurol.2013.4021
↑ van Gijn J, Rinkel GJ (2001). “Subarachnoid haemorrhage: diagnosis, causes and management”. Brain. 124 (Pt 2): 249–78. PMID 11157554.
↑ Bromberg JEC, Rinkel GJE, Algra A, Greebe P, van Duyn CM, Hasan D, et al. Subarachnoid haemorrhage in first and second degree relatives of patients with subarachnoid haemorrhage. BMJ 1995; 311: 288–9.
↑ Schievink, Wouter I., et al. “Saccular intracranial aneurysms in autosomal dominant polycystic kidney disease.” Journal of the American Society of Nephrology 3.1 (1992): 88-95.
↑ Van den Berg, J. S. P., M. Limburg, and R. C. M. Hennekam. “Is Marfan syndrome associated with symptomatic intracranial aneurysms?.” Stroke 27.1 (1996): 10-12
↑ Teunissen LL, Rinkel GJE, Algra A, van Gijn J. Risk factors for subarachnoid hemorrhage – a systematic review. Stroke 1996; 27: 544–9.

Template:WS Template:WH

[Huhtakangas-1] Huhtakangas J, Tetri S, Juvela S, Saloheimo P, Bode MK, Hillbom M. Effect of increased warfarin use on warfarin-related cerebral hemor- rhage: a longitudinal population-based study. Stroke. 2011;42:2431– 2435. doi: 10.1161/STROKEAHA.111.615260.

[Rådberg-2] Rådberg JA, Olsson JE, Rådberg CT. Prognostic parameters in sponta- neous intracerebral hematomas with special reference to anticoagulant treatment. Stroke. 1991;22:571–576. doi: 10.1161/01.STR.22.5.571.

[Flaherty-3] Flaherty ML, Kissela B, Woo D, Kleindorfer D, Alwell K, Sekar P, Moomaw CJ, Haverbusch M, Broderick JP. The increasing incidence of anticoagulant-associated intracerebral hemorrhage. Neurology. 2007;68:116–121. doi: 10.1212/01.wnl.0000250340.05202.8b.

[Chatterjee-4] Chatterjee S, Sardar P, Biondi-Zoccai G, Kumbhani DJ. New oral anticoagulants and the risk of intracranial hemorrhage: traditional and Bayesian meta-analysis and mixed treatment comparison of random- ized trials of new oral anticoagulants in atrial fibrillation. JAMA Neurol. 2013;70:1486–1490. doi: 10.1001/jamaneurol.2013.4021

[pmid11157554-5] van Gijn J, Rinkel GJ (2001). “Subarachnoid haemorrhage: diagnosis, causes and management”. Brain. 124 (Pt 2): 249–78. PMID 11157554.

[Bromberg-6] Bromberg JEC, Rinkel GJE, Algra A, Greebe P, van Duyn CM, Hasan D, et al. Subarachnoid haemorrhage in first and second degree relatives of patients with subarachnoid haemorrhage. BMJ 1995; 311: 288–9.

[Schievink-7] Schievink, Wouter I., et al. “Saccular intracranial aneurysms in autosomal dominant polycystic kidney disease.” Journal of the American Society of Nephrology 3.1 (1992): 88-95.

[Van-den-8] Van den Berg, J. S. P., M. Limburg, and R. C. M. Hennekam. “Is Marfan syndrome associated with symptomatic intracranial aneurysms?.” Stroke 27.1 (1996): 10-12

[Teunissen-9] Teunissen LL, Rinkel GJE, Algra A, van Gijn J. Risk factors for subarachnoid hemorrhage – a systematic review. Stroke 1996; 27: 544–9.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]