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FND – Hoover Sign — SCE Neurology MCQ

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HardNeuropsychiatryFND – Hoover SignSCE Neurology

A 74-year-old taking aspirin for primary prevention has a spontaneous lobar intracerebral haemorrhage. There is no planned emergency neurosurgery and the platelet count is normal. Which haemostatic approach is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Stop aspirin and omit platelet transfusion from the acute ICH bundle

Explanation lettering: C = shown as A · A = shown as B · E = shown as C · B = shown as D · D = shown as E

A is not supported and platelet transfusion may worsen outcome in non-surgical aspirin-associated ICH. B adds an unsupported routine antifibrinolytic strategy. C is correct: stop the antiplatelet, avoid routine platelet transfusion and prioritise rapid blood-pressure control, anticoagulant review, neurosurgical and critical-care assessment. D does not remove irreversibly acetylated platelets. E has no compelling primary-prevention indication and is unsafe acutely.

Reference: Acute intracerebral haemorrhage: diagnosis and management: https://pn.bmj.com/content/21/2/128