Association of Selective #Serotonin Reuptake Inhibitors With the Risk for Spontaneous Intracranial #Hemorrhage

https://www.ncbi.nlm.nih.gov/pubmed/27918771

The use of SSRIs and more generally of antidepressants with strong inhibition of serotonin reuptake are associated with an increased risk for ICH, particularly in the first 30 days of use and when used concomitantly with oral anticoagulants

Evolving use of #seizure medications after intracerebral #hemorrhage

http://m.neurology.org/content/88/1/52.abstract

New data that led to revised prescribing guidelines for prophylactic seizure medications for patients with ICH were temporally associated with a significant decrease in use of the medication, potentially reducing adverse outcomes. However, a corresponding increase in the use of an alternative medication, levetiracetam, occurred despite limited knowledge about its potential effects on outcomes. Future guideline changes should anticipate and address alternatives.

Resumption of Oral #Anticoagulation After Intracerebral #Hemorrhage is Associated With Decreased Mortality and Favorable Functional Outcome

http://www.abstractsonline.com/pp8/#!/4172/presentation/13142

OAT resumption was associated with decreased mortality and favorable outcome after both non-lobar and lobar ICH. These findings support conducting randomized clinical trials to explore risks and benefits of OAT resumption after ICH

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#Hypertension and intracerebral #hemorrhage recurrence among white, #black, and Hispanic individuals

http://n.neurology.org/content/early/2018/06/06/WNL.0000000000005729


We followed 2,291 ICH survivors (1,121 white, 529 black, 605 Hispanic, and 36 of other race/ethnicity). Both black and Hispanic patients displayed higher SBP during follow-up (p < 0.05). Black participants also displayed greater SBP variability during follow-up (p = 0.032). In univariable analyses, black and Hispanic patients were at higher ICH recurrence risk (p < 0.05). After adjusting for BP measurements and their variability, both Hispanic (hazard ratio = 1.51, 95% confidence interval 1.14–2.00, p = 0.004) and black (hazard ratio = 1.98, 95% confidence interval 1.36–2.86, p < 0.001) patients remained at higher risk of ICH recurrence.

Conclusion Black and Hispanic patients are at higher risk of ICH recurrence; hypertension severity (average BP and its variability) does not fully account for this finding. Additional studies will be required to further elucidate determinants for this health disparity.

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Frequency of Intracranial #Hemorrhage With Low-Dose #Aspirin in Individuals Without Symptomatic Cardiovascular Disease

https://jamanetwork.com/journals/jamaneurology/article-abstract/2732929

Use of low-dose aspirin for the primary prevention of cardiovascular events remains controversial because increased risk of bleeding may offset the overall benefit. Among major bleeding events, intracranial hemorrhage is associated with high mortality rates and functional dependency

Pooling the results from the random-effects model showed that low-dose aspirin, compared with control, was associated with an increased risk of any intracranial bleeding (8 trials; relative risk, 1.37; 95% CI, 1.13-1.66; 2 additional intracranial hemorrhages in 1000 people), with potentially the greatest relative risk increase for subdural or extradural hemorrhage (4 trials; relative risk, 1.53; 95% CI, 1.08-2.18) and less for intracerebral hemorrhage and subarachnoid hemorrhage. Patient baseline features associated with heightened risk of intracerebral hemorrhage with low-dose aspirin, compared with control, were Asian race/ethnicity and low body mass index.

Conclusions and Relevance Among people without symptomatic cardiovascular disease, use of low-dose aspirin was associated with an overall increased risk of intracranial hemorrhage, and heightened risk of intracerebral hemorrhage for those of Asian race/ethnicity or people with a low body mass index.

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Low-density #lipoprotein cholesterol and risk of intracerebral #hemorrhage
A prospective study

https://n.neurology.org/content/early/2019/07/02/WNL.0000000000007853

We identified 753 incident ICH cases during 9 years of follow-up. The ICH risk was similar among participants with LDL concentrations of 70 to 99 mg/dL and those with LDL-C concentrations ≥100 mg/dL.

In contrast, participants with LDL-C concentrations <70 mg/dL had a significantly higher risk of developing ICH than those with LDL-C concentrations of 70 to 99 mg/dL;

adjusted hazard ratios were 1.65 (95% confidence interval CI 1.32–2.05) for LDL-C concentrations of 50 to 69 mg/dL and 2.69 (95% CI 2.03–3.57) for LDL-C concentrations <50 mg/dL.

Conclusions

We observed a significant association between lower LDL-C and higher risk of ICH when LDL-C was <70 mg/dL, and the association became nonsignificant when LDL-C ≥70 mg/dL. These data can help determination of the ideal LDL range in patients who are at increased risk of both atherosclerotic disease and hemorrhagic stroke and guide planning of future lipid-lowering studies.

Obstructive Sleep #Apnea as a Risk Factor for Intracerebral #Hemorrhage
https://2medical.news/2021/04/14/obstructive-sleep-apnea-as-a-risk-factor-for-intracerebral-hemorrhage/

To determine whether obstructive sleep apnea (OSA) is associated with intracerebral hemorrhage (ICH) risk, we assessed premorbid OSA exposure of patients with nontraumatic ICH and matched controls. Methods: Ethnic/Racial Variations of Intracerebral Hemorrhage is a multicenter, case-control study evaluating risk factors for ICH that recruited 3000 cases with ICH and 3000 controls. OSA status was ascertained using the Berlin Questionnaire as a surrogate for premorbid …

Prescribed Drug Use and #Aneurysmal Subarachnoid #Hemorrhage IncidenceA Drug-Wide Association Study

https://2medical.news/2024/06/14/prescribed-drug-use-and-aneurysmal-subarachnoid-hemorrhage-incidencea-drug-wide-association-study/