Spontaneous (nontraumatic) intracerebral hemorrhage (ICH) is the most dramatic type of stroke being responsible for the majority of mortality and stroke-related disability. ICH survivors seem to be at high risk of major vascular events with an ICH annual recurrence risk varying from 1.3% to 7.4%. While patients and clinicians are mainly concerned with recurrent ICH, ischemic arterial events may be at least as frequent, raising important therapeutic dilemmas around the clinical benefit of antithrombotic agents.

In a study published in Stroke in April, 2019, ICH survivors were identified as being at a high risk of both cerebral and extracerebral vascular events. The ischemic or hemorrhagic risk profile varied however secondary prevention should target not only cerebral recurrences but also extracerebral vascular events. The study also identified that the location of the ICH in the brain had a definite impact on future events.

Many of our residents have experienced brain bleeds and/or ischemic events that have left them compromised to some degree. Wouldn’t it be a beautiful thing if we had more information on how to prevent another event? The thought that an ischemic event could be influenced by an ICH is interesting, two different types of events but both high risk for negative outcomes. Be alert to sudden changes in your resident’s condition, remember, it might make a huge difference in their overall health status! Stay well, mask up indoors and stay tuned!