1(E) Intracranial Haemorrhage Flashcards
What is intracranial haemorrhage
Bleeding within ventricles
In which population does intraventricular haemorrhage occur
Pre-mature neonates
Rare in adults
Why does intraventricular haemorrhage happen in pre-mature neonates
Due to pre-maturity of periventricular vessels
What can cause inter ventricular haemorrhage in adults
- Extension SAH
- Vascular lesions (AV malformation, Aneurysm)
In pre-mature neonates, when will intraventricular haemorrhage occur
Several days following birth
What is the management of intraventricular haemorrhage
VP Shunt to divert CSF
What is the main complication if intraventricular haemorrhage
Obstructive hydrocephalus
What is subarachnoid haemorrhage
Bleeding into subarachnoid space
What are the two etiological categories of SAH
- Traumatic
- Non-traumatic
What is the most common cause of SAH
Most common
What is the most common cause of non-traumatic SAH
Berry aneurysm
In which gender are berry aneurysms more common
Female (3:2)
In which artery are berry aneurysms more common
Anterior communicating artery
What are 4 other causes of SAH
- AV malformation
- Pituitary apoplexy
- Mycotic aneurysm
- Carotid artery dissection
Give 3 conditions associated with berry aneurysm formation
ADPKD
Ehlers-Danlos
Coarctation aorta
What are 4 risk factors for berry aneurysm
Smoking Cocaine and amphetamine use HTN Alcohol FH
How does SAH present clinically
- Sudden-onset occipital thunderclap headache - sentinel headache beforehand.
- Nausea and Vomitting
- LOC
- Seizures
Meningism:
- Stiff neck
- Headache
- Photophobia
What are signs of meningism
Brudzinski
Kernig
When is Kernig sign first positive
6-hours following onset
What syndrome is associated with SAH
Terson syndrome
What is Terson’s syndrome
Retinal, Subhyaloid and vitreous bleeds
What is the problem with Terson’s syndrome
5-times risk of mortality
What ECG changes are present in SAH
ST elevation
What immediate investigation is ordered in SAH
CT-head
What other investigation is ordered in SAH
CT angiography
LP