Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Neurology Week 5 2018/19 > 3: Intracranial haemorrhage > Flashcards

3: Intracranial haemorrhage Flashcards

1
Q

Intracranial haemorrhage can be spontaneous or brought on by a ___ ___.

A

head injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What underlying pathology is usually responsible for subarachnoid haemorrhage?

A

Berry aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a congenital problem which can cause subarachnoid haemorrhage?

A

AVM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The subarachnoid space is found between the ___ and the ___.

A

arachnoid, pia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which type of haemorrhage is relatively common and may be related to a Berry aneurysm?

A

Subarachnoid haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which circulation does a Berry aneurysm affect?

A

Circle of Willis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where in the Circle of Willis do Berry aneurysms tend to form?

A

Bifurcations

branch points between one artery and the next

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the presentation of a subarachnoid haemorrhage?

A

Headache - sudden & severe; “worst headache of my life”; persistent

Syncope

Vomiting - almost always

Neck pain - irritation of meninges in spinal cord subarachnoid space

Photophobia - “”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Subarachnoid haemorrhage and meningitis have similar presentations.

How do you tell the difference?

A

Subarachnoid haemorrhage presents with sudden onset headache

Meningitis headache has a gradual onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why do headaches seen in subarachnoid haemorrhage have a sudden onset?

A

Aneurysm collapses and SYSTOLIC BP transferred into parenchyma (i.e it occurs very quickly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of meningitis is caused by subarachnoid haemorrhage?

A

Chemical meningitis - due to the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which type of headache may mimic that of a subarachnoid haemorrhage?

How would you tell the difference?

A

Migraine

Aura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is benign coital cephalgia?

A

Sudden onset headache during / after sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the clinical signs of subarachnoid haemorrhage?

A

Neck stiffness

Photophobia

Reduced conscious level

Focal neurological deficit e.g CN palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which cranial nerve palsy is associated with brain aneurysms?

Which artery is implicated?

A

CN III palsy“down and out”

Posterior communicating artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the first-line investigation for patients with subarachnoid haemorrhages?

A

CT brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Is a CT brain 100% specific for subarachnoid haemorrhage?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What colour is fresh blood on a CT scan?

A

White

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What colour is CSF on a CT scan?

A

Black

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Where will blood be seen on a CT brain of someone with a subarachnoid haemorrhage?

A

Fissures, cisterns

i.e not in the ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

A CT brain is the first-line investigation for subarachnoid haemorrhage, but it may be negative.

What is the gold standard investigation?

What is seen in subarachnoid haemorrhage?

A

Lumbar puncture

Bloody / “xanthochromic” CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is xanthochromia in terms of a CSF sample?

A

Yellow-ish staining of CSF - blood breakdown products; indicative of subarachnoid haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do you tell the difference between bloodstained CSF (in subarachnoid haemorrhage) and a traumatic tap?

A

Take three samples

if amount of blood decreases with each tap, it’s traumatic

24
Q

Which imaging can be used to visualise blood vessels in cerebrovascular disease?

A

CT / MRI angiography

25
How long does bleeding actually last for in a subarachnoid haemorrhage?
**\< 1 second** because of compression, vasospasm etc. closing the bleed
26
**Aneurysms** which have burst are at major risk of ____ in the next two weeks.
**rebleeding** fatal complication of subarachnoid haemorrhage
27
How is **rebleeding** prevented in patients with ruptured cerebral aneurysms?
**Endovascular techniques** feeding through a catheter and planting metal coils
28
Metal coils are implanted using a catheter to prevent ___ of ruptured aneurysms.
**rebleeding**
29
Apart from **endovascular techniques**, what else can be used to stop aneurysms from rebleeding?
**Surgical clips**
30
What is a complication of **subarachnoid haemorrhage** which can occur **3 - 12 days** following a bleed?
**Delayed ischaemia**
31
What causes **delayed ischaemia** following subarachnoid haemorrhage?
**Vasospasm**
32
How is **delayed ischaemia** prevented?
**High fluid intake** - dehydration increases chances of vasospasm **Nimodipine** - CCB which decreases chances of vasospasm
33
How does **delayed ischaemia** present in patients following a subarachnoid haemorrhage?
**Global** - reduced conscious level or **focal neurological deficit**
34
How does **infarction** look on brain imaging?
**Black**
35
Why can **subarachnoid haemorrhage** cause **hydrocephalus**?
**Bleeding into SS increases CSF pressure \> ICP** **Blood clogs up subarachnoid granulations, reducing reabsorption**
36
How is **hydrocephalus** secondary to **subarachnoid haemorrhage** treated?
**CSF drainage** either temporary: lumbar puncture or permanent: shunt
37
Which **metabolic** problem is seen following **subarachnoid haemorrhage**? Which brain structure is thought to cause this?
**Hyponatraemia** **Hypothalamus**
38
Which two **processes** are thought to cause **hyponatraemia** in patients following a **subarachnoid haemorrhage**?
**SIADH** - something to do with the hypothalamus ## Footnote **Cerebral salt wasting**
39
Which artery supplies the **hypothalamus**?
**Anterior communicating artery**
40
How is **hyponatraemia** following subarachnoid haemorrhage managed?
**Fludrocortisone** - aldosterone analogue, increases Na+ reabsorption by kidneys **Na**+ **supplements** **NO fluid restriction**
41
Should patients with **hyponatraemia** following subarachnoid haemorrhage be **fluid restricted?**
**No**
42
What is the biggest clinical feature of **subarachnoid haemorrhage**?
**Headache** - sudden onset, severe, constant
43
How is subarachnoid haemorrhage managed initially?
**Analgesia** **Fluids** **Anti-emetic**
44
How is subarachnoid haemorrhage investigated?
**CT brain** **Lumbar puncture** +/- angiography
45
What is **bleeding into the brain parenchyma** called?
**Intracerebral haemorrhage**
46
Most **haemorrhagic strokes** are caused by (**subarachnoid / intracerebral)** haemorrhages.
**intracerebral**
47
What is the biggest risk factor for intracerebral haemorrhage?
**Hypertension**
48
Which type of **aneurysm** is associated with **intracerebral haemorrhage**? What risk factor causes them to develop?
**Charcot-Bouchard aneurysms** **Hypertension**
49
What are the symptoms of intracranial haemorrhage?
**Headache** **Focal neurological deficit** **Decreased conscious level** if severe
50
How is **intracranial haemorrhage** investigated?
**CT brain** **Angiography**
51
What can be seen on a CT scan of someone with an **intracranial haemorrhage?**
**Haematoma(s)**
52
Under which circumstances are patients with **intracerebral haemorrhage** operated on?
**Decreased conscious level** **Evidence of AVM** otherwise management is non-surgical
53
Which brain structures, responsible for modifying movement information, may be involved in an intracerebral haemorrhage?
**Basal ganglia**
54
What is an **intraventricular haemorrhage?**
**Blood in the ventricles**
55
How does an **intraventricular haemorrhage** look on head imaging?
**White (lucent) blood in the ventricles** as patients are lying on their backs for the scan, CSF rises to the top, so sorta a black/white divide in the ventricles
56
Which type of haemorrhage do **AVMs** tend to cause?
**Intracerebral haemorrhage**

Neurology Week 5 2018/19 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions