Pharmacist's Guide to Common Intracranial Bleeding Terms and Treatments

Area of Science:

• Neuroscience
• Pharmacology
• Critical Care Medicine

Background:

• Intracranial hemorrhages, including subarachnoid hemorrhage (SAH) and subdural hematoma (SDH), are often imprecisely referred to as "head bleeds."
• These life-threatening conditions possess distinct etiologies and require tailored treatment paradigms.

Purpose of the Study:

• To review common intracranial hemorrhage types.
• To highlight the differences in management strategies for various "head bleed" presentations.
• To inform pharmacists about optimizing care for neurocritical patients with intracranial bleeding.

Main Methods:

• A narrative review of common intracranial hemorrhage types.
• Consideration of relevant studies and clinical guidelines.

Main Results:

• Intracerebral hemorrhage (ICH), SAH, and SDH are distinct radiographic entities within the "head bleed" classification.
• Management varies significantly, with surgery indicated for some (SDH, SAH) but not others (ICH).
• Pharmacotherapy for coagulopathy reversal and elevated intracranial pressure may share similarities, but seizure prophylaxis and blood pressure control are hemorrhage-specific.

Conclusions:

• Each intracranial bleeding type presents unique challenges regarding surgical intervention, neurologic monitoring, and hemodynamic management.
• Pharmacists require specialized knowledge of differing surgical and pharmacotherapeutic approaches to effectively manage patients with various intracranial hemorrhages.