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Abstract Details

Frequency and yield of follow-up imaging after spontaneous non-traumatic, non- aneurysmal intracranial hemorrhage: A safety-net hospital experience
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
093
Determine the frequency and yield of follow-up neuroimaging after hospital discharge in patients with spontaneous non-traumatic, non-aneurysmal intracranial hemorrhage (SICH).
The majority of SICHs are attributed to chronic hypertension, however approximately 20% of cases are due to other etiologies. Hence, delayed neurovascular and/or brain imaging can be helpful to diagnose macrovascular etiologies underlying the SICH. Use of this imaging strategy in practice is variable and the yield is largely unknown.
A retrospective review was performed on all ICH patients admitted to an urban safety net hospital between 1/1/2016 and 12/31/2018 that is in Jacksonville, Florida. Collected data included demographics, presumptive ICH etiology, completion of a neurology outpatient visits after hospitalization, and results of delayed imaging studies. Clinic notes were reviewed to determine if follow-up imaging changed the presumptive SICH etiology and if macrovascular causes were identified.
Of 300 patients with ICH, 86 (29%) had a SICH. Mean age was 71 and 47% were black. Short term mortality was 53% (46/80). Of the 40 survivors, 22 returned for outpatient follow- up. Imaging was performed on 20 (MRI in 11, CT head in 7, CTA head in 2). A change in presumptive ICH etiology was made in 2/20 (one from chronic HTN to cerebral amyloid angiopathy, and one from unknown to malignancy).
Only a minority of SICH patients had a neuroimaging study conducted after discharge. In part, this related to the high mortality rate in our cohort, but approximately one-half of survivors were not evaluated as outpatients following their hospitalization. Nearly all patients who were seen in follow-up had a new neuroimaging study, and the study did alter the etiologic diagnosis in 10%. Devising strategies that augment follow- up for SICH survivors at safety net hospitals may lead to a reduction in secondary strokes within the communities these hospitals serve. 
Authors/Disclosures
Ravi Pande, MD
PRESENTER 		Dr. Pande has nothing to disclose.
No disclosure on file
Scott L. Silliman, MD (U.F. College of Medicine-Jacksonville) Dr. Silliman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech.