Raza Syed Ali, Durm Laura Beth, Mahmoud Ghada A, Rahman Haseeb, Henriquez Laura, Davis Brittaine, Nahab Fadi
Department of Neurology, Emory University Department of Neurology, Emory University Hospital, Atlanta, GA Department of Neurology, Henry Ford Health System, Detroit, MI, USA.
Medicine (Baltimore). 2018 Apr;97(15):e0334. doi: 10.1097/MD.0000000000010334.
Over-the-counter (OTC) analgesics including aspirin-containing powder formulations (BC Powder, Goody's Powder) (ACPFs) are commonly utilized in the United States. While the ACPFs have been associated with upper gastrointestinal bleeding, we describe a case series of patients presenting with intracerebral hemorrhage (ICH) within 24 hours of ingestion.
We reviewed all ICH patients presenting to a comprehensive stroke center from September 1, 2014 through June 30, 2016 to identify patients who reported taking BC Powder or Goody's Powder within 7 days of their stroke. Baseline characteristics, medication use, stroke risk factors, clinical imaging, and laboratory testing were reviewed retrospectively.
Of 334 patients admitted with ICH during the study period, 6 (2%) reported use of OTC analgesic powders within 1 week of their index stroke. All had consumed at least 1 packet within 24 hours of their ICH. All patients were African American and all except 1 patient were females. Three patients had no identified traditional stroke risk factors and 3 other patients had evidence of mild hypertension history.
Over-the-counter analgesic powders containing high doses of aspirin including BC Powder and Goody's Powder may contribute to ICH in patients with no or minimal risk factors. Providers should inquire about the use of these powders in ICH patients particularly among African Americans.
非处方（OTC）镇痛药，包括含阿司匹林的粉剂配方（BC粉、古迪粉）在美国被广泛使用。虽然含阿司匹林的粉剂配方与上消化道出血有关，但我们描述了一系列在摄入后24小时内出现脑出血（ICH）的患者病例。
我们回顾了2014年9月1日至2016年6月30日期间在一家综合性卒中中心就诊的所有脑出血患者，以确定那些在卒中发作7天内报告服用过BC粉或古迪粉的患者。对患者的基线特征、用药情况、卒中危险因素、临床影像学和实验室检查进行了回顾性分析。
在研究期间收治的334例脑出血患者中，6例（2%）报告在首次卒中发作1周内使用过非处方镇痛药粉剂。所有患者在脑出血发作24小时内均至少服用了1包。所有患者均为非裔美国人，除1例患者外均为女性。3例患者未发现传统的卒中危险因素，另外3例患者有轻度高血压病史。
含高剂量阿司匹林的非处方镇痛药粉剂，包括BC粉和古迪粉，可能会导致无或仅有极少危险因素的患者发生脑出血。医疗服务提供者应询问脑出血患者，尤其是非裔美国人，是否使用过这些粉剂。
