FOLLOW UP to:'Hemorrhagic stroke...'(12-9-98)

[David__0__0]

  Can you address the questions posed in my post of 12-9-98 but relating to
  ICH rather that SAH?  My inquiry concerns a patient of 78 years age with
  high normal BP who had an large ICH four years ago.  Initial effects were
  profound -- total paralysis of left arm from shoulder down and left leg
  nearly as involved(could swing from the hip, but not support weight or
  control below hip).  Recovery was complete, with only slight residual
  weakness.
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Dear David,
There are risks to anything we do in the medical field.  If this patient had the ICH four years ago the risk to rebleed with controlled blood pressure is low, even with some heparin on board.  The risk, however, is not as low as someone who hasn't bled at all.  The necessity of the catheterization procedure is often pressing enough to warrant such risk.  Often the physicians doing the catheterization procedure can either limit or eliminate the use of heparin in riskier patients when necessary.  
Speak to the physicians about these issues to be sure they know of the bleed in the past.  Usually there isn't a problem doing the procedure this far out from the bleed.
Good luck.