The Rational Clinical Examination
David L. Simel, Drummond Rennie
Stroke, Hemorrhagic
David L. Simel
Make the Diagnosis: Does This Patient Have a Hemorrhagic Stroke?
Topics Discussed:
cerebral hemisphere hemorrhage, cerebrovascular accident, criterion standard comparisons (diagnostic tests), diagnostic process, intracranial hemorrhages, likelihood ratio, make the diagnosis, prior probability
Excerpt:
"Once a patient has had a stroke1 (see Table
48-10 in Chapter 48: Stroke), the clinician must move quickly to
identify those with hemorrhagic etiologies. While most strokes are
ischemic, the prevalence of hemorrhagic stroke is 24%,
though there is geographic variability with studies from the United
States and Europe showing a lower prevalence of 15% (95% CI,
24%-35%).2 Less than 3% of
patients will have conditions that mimic stroke (eg, a tumor, subdural
hematoma, or intracranial infection)...."
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