SURVEY ON MANAGEMENT OF POST THROMBOLYSIS SYMPTOMATIC INTRA CEREBRAL HAEMORRHAGE Introduction Symptomatic intra-cerebral haemorrhage (SICH) is potentially a fatal complication of thrombolysis when treating acute ischemic stroke. The incidence and mortality of the post-thrombolysis SICH is 3.3% and 52.3% respectively. We aimed to explore how SICH are treated worldwide and which treatment option yields the greatest success. Methods A 12-question survey was devised using SurveyMonkey. The survey was distributed electronically to members of the European Stoke Society and World Stroke Organisation in December 2017 and remained open for 12 days. The responses were analysed using descriptive statistics and qualitative comments to open-ended questions were analysed through thematic analysis. Results There were 64 responses in total with the majority from stroke physicians. The responses were mostly from Europe. The three most common risk factors identified for SICH following thrombolysis were stroke severity, uncontrolled hypertension and previous anti-platelets and/or anti-thrombotics use (45%, 40% and 16% respectively). The SICH incident in most hospitals was between 3-6%. The most commonly used management included fresh frozen plasma (41%) and cryoprecipitate (24%). Less commonly used treatment included vitamin K (9%), aminocaproic acid (6%), tranexamic acid (6%) and platelet transfusion (6%). However the majority of the individual answers highlighted that no particular management option yielded the best result, but all had similar outcomes. 75% of the respondent felt that the SICH associated mortality was <50% whilst 20% found mortality around 80%. Conclusion Overall all the respondents agree that SICH associated mortality is very high. Urgent research should be undertaken with newer agents to improve the outcome of the patients.
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