Intracranial Hemorrhage in Persons with Hemophilia:
Risk Factors, Diagnosis, and Management

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Release Date: February 6, 2017
Expiration Date: February 6, 2018
Estimated Time to Complete Activity: 60 minutes
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Target Audience

This activity has been designed to meet the educational needs of hematologists, physicians, physician assistants, nurse practitioners, advanced practice registered nurses, registered nurses, physical therapists, social workers, and other specialists of the hemophilia treatment center (HTC) team, as well as other healthcare providers interested in new developments in the management of complications in patients with hemophilia (PWH).

Statement of Need/Program Overview

Intracranial hemorrhage (ICH) is the most serious bleeding symptom in PWH, resulting in high rates of mortality and disabling neurologic sequelae. The optimal management of ICH in PWH depends on immediate recognition and prompt replacement therapy to ensure hemostatic balance with adequate surgical intervention. Many questions remain regarding screening for ICH in the newborn, optimal methods of detection, length of therapy, and methods to prevent ICH in older PWH.

Educational Objectives
After participating in this activity, participants should be able to:
  • Review the risk factors, clinical symptoms, and methods for diagnosis of intracranial hemorrhage (ICH) in patients with hemophilia (PWH)
  • Discuss the challenges in identifying the clinical signs and the timely diagnosis of ICH in neonates, children, and adults with hemophilia
  • Discuss current recommendations regarding care and management of a pregnant woman who is a carrier of hemophilia, in order to minimize the risk of ICH at delivery
  • Assess current data and expert opinion on preventing and managing the sequelae of ICH in neonates, children, and adults with hemophilia
  • Implement new strategies for the prevention and optimal management of ICH in PWH

Presenting Faculty

Margaret A. Heisel-Kurth, MD
Margaret A. Heisel-Kurth, MD
Associate Professor
University of Minnesota Medical School
Center for Bleeding and Clotting Disorders
Children's Hospitals and Clinics of Minnesota
Minneapolis, Minnesota

Mark T. Reding, MD
Mark T. Reding, MD
Associate Professor of Medicine
Division of Hematology, Oncology, and Transplantation
Director, Center for Bleeding and Clotting Disorders
University of Minnesota Medical School
Minneapolis, Minnesota
 

Tammuella “Tami” Chrisentery Singleton, MD
Tammuella “Tami” Chrisentery Singleton, MD
Assistant Professor of Medicine and Pediatrics Section
Chief, Pediatric Hematology/Oncology
Louisiana Center for Bleeding and Clotting Disorders
Tulane University School of Medicine
New Orleans, Louisiana

Physician Continuing Medical Education
Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Postgraduate Institute for Medicine, the Cardiovascular & Metabolic Health Foundation, and Educational Concepts in Medicine. Postgraduate Institute for Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
Postgraduate Institute for Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing Continuing Education
Credit Designation
This educational activity for 1.0 contact hours is provided by Postgraduate Institute for Medicine.
Designated for 0.5 contact hours of pharmacotherapy credit for Advance Practice Registered Nurses.

Accreditation Statement
Postgraduate Institute for Medicine is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Method of Participation
During the period of February 6, 2017, through February 6, 2018, participants must:

  • Read the learning objectives and faculty disclosures
  • Study the educational activity
  • Complete the posttest by recording the best answer to each question
  • Complete the evaluation form

A statement of credit will be issued automatically upon successfully completing the post-activity survey with a score of 75% or better and submitting the activity evaluation.

Fee Information
There is no fee for this educational activity.

Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by PIM for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

PIM is committed to providing its learners with high-quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Name of Faculty or Presenter Reported Financial Relationship
Margaret Heisel-Kurth, MD Has no real or apparent conflicts of interest to report.
Mark Reding, MD

Consulting Fees: Bayer, Baxalta, Biogen, Novo Nordisk; Fees for Non-CME/CE Services: Baxalta, Biogen, Sobi

Tammuella Chrisentery Singleton, MD

Consulting Fees: Novo Nordisk, Shire, CSL Behring, Octapharma, Biogen, Grifols, BPL Other Speakers Bureau: Novo Nordisk, Shire, Grifols, CSL Behring

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
Name of Planner or Manager Reported Financial Relationship
PIM Clinical Reviewers: Trace Hutchison, PharmD; Samantha Mattiucci, PharmD, CHCP; Judi Smelker-Mitchek, RN, BSN; Jan Schultz, RN, MSN, CHCP

Have no real or apparent conflicts of interest to report.

Educational Concepts in Medicine: Patrick J. Crowley, MBA, President/CEO; Jodi Andrews, Vice President, Operations; Larry Rosenberg, PhD, Medical Writer; Helen Morfit, BA, Program Director Have no real or apparent conflicts of interest to report.


Media
Internet

Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.