The patient history (medical history) represents an important component in the diagnosis of intracerebral hemorrhage.
The patient is admitted to the hospital as a medical emergency. As a rule, the patient is unresponsive, so that the anamnesis interview is conducted with relatives or contact persons (= external anamnesis).
Family history
- Are there frequent coagulation disorders, cardiovascular diseases, neurological diseases or tumor diseases in your family?
Current medical history/systemic history (somatic and psychological complaints).
- Has there been an accident?
- Are you suffering from a sudden onset of a violent headache?* .
- Was there a loss of consciousness?* (foreign anamnesis).
- Did you notice symptoms such as gait unsteadiness, paralysis, dizziness, visual disturbances, sensory loss, or speech disturbances?* .
- Did epileptic seizures occur?*
- Do you have any other complaints, if any, such as.
- Nausea
- Vomiting
- If so, how long have these symptoms existed or did they occur abruptly?*
- Have these symptoms occurred before?*
Vegetative anamnesis including nutritional anamnesis.
- Are you overweight? Please tell us your body weight (in kg) and height (in cm).
- Do you exercise enough every day?
- Do you smoke? If so, how many cigarettes, cigars or pipes per day?
- Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
- Do you use drugs? If yes, what drugs (amphetamines, crystal meth, cocaine) and how often per day or per week?
Self-history
- Previous diseases (hypertension!, vascular diseases, coagulation disorders, tumors).
- Operations
- Allergies
- Pregnancy
Medication history
- Anticoagulants
- Coumarins (phenprocoumon* (product names: Marcumar, Falithrom); warfarin (product names: Coumadin, Marevan); acenocoumarol (product name: Sintrom).
- Direct inhibitors of thrombin (Argatroban, Lepirudin).
- Heparin analogues (fondaparinux).
- Heparins (certoparin, dalteparin, enoxaparin, nadroparin, reviparin, tinzaparin).
- Heparinoids (danaparoid
- New oral anticoagulants (NOAK; NOAC; direct oral anticoagulants, DOAK).
- Direct factor Xa inhibitor (apixaban, edoxaban, rivaroxaban).
- Direct and selective factor Xa inhibitor (apixaban).
- Selective thrombin inhibitor (dabigatran); antidote: idarucizumab can reverse the effect of the oral anticoagulant dabigatran within minutes; bleeding stops within 2.5 hours-but there may be a rebound in bleeding times after 12 to 24 hours, leading to rebleeding in some patients.
- Antiplatelet agents (abciximab, acetylsalicylic acid (ASA), combination of acetylsalicylic acid and dipyridamole, clopidogrel, eptifibatide, ilomedin (prostacyclin analog), prasugrel, ticagrelor, ticlopidine, tirofiban)Low-dose (up to 300 mg/day) continuous medication with acetylsalicylic acid (ASA; Antiplatelet agents), as prescribed in the primary and secondary prevention of vascular events, does not increase the risk of intracranial hemorrhage.
- Fibrinolytics (drugs used for the acute treatment of conditions caused by vascular occlusion; they cause the blood clot to dissolve).
- Hormones – e.g. combined hormonal contraceptive (contraceptive) → cerebral venous and/or sinus thrombosis.
* If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Information without guarantee)
Note: If intracerebral hemorrhage is suspected, it is always an emergency!
