Diagnostic Approach

The diagnostic approach for patients presenting with hemorrhagic stroke involves a combination of clinical assessment, imaging studies, and laboratory investigations. Early and accurate diagnosis is essential to guide appropriate management strategies and determine the underlying cause of the hemorrhage.

1. Clinical Assessment:
   ● A thorough history and physical examination are crucial in identifying symptoms, risk factors, and potential causes of hemorrhagic stroke.
   ● The assessment includes a detailed neurological examination to determine the location and extent of neurologic deficits.
2. Imaging Studies:
   ● Non-contrast Computed Tomography (CT) Scan: This is the initial imaging modality of choice for suspected hemorrhagic stroke. It helps identify the presence, location, and size of the hemorrhage, allowing for immediate intervention and differentiation from ischemic stroke.
   ● Computed Tomography Angiography (CTA): CTA is commonly performed to evaluate the blood vessels and detect underlying vascular abnormalities or aneurysms that may have caused the hemorrhage.
   ● Magnetic Resonance Imaging (MRI): MRI may be used to provide more detailed information about the brain and blood vessels, especially in cases where the CT scan is inconclusive or additional characterization is required.
3. Laboratory Investigations:
   ● Complete Blood Count (CBC): To assess platelet count and other blood cell parameters.
   ● Coagulation Studies: Including Prothrombin Time (PT), Activated Partial Thromboplastin Time (aPTT), and International Normalized Ratio (INR) to evaluate the coagulation profile.
   ● Additional Tests: Depending on the clinical context, other investigations such as genetic testing, bleeding disorder workup, or toxicology screening may be considered.
   

It is important to promptly initiate the diagnostic workup to determine the underlying cause of hemorrhagic stroke, as it can guide further management decisions and the implementation of appropriate preventive measures.