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Neuro - Post Midterm > 64 Clinical Intracerebral Hemorrhage > Flashcards

64 Clinical Intracerebral Hemorrhage Flashcards

1
Q

Terminology

  • What is the difference between an intracranial hemorrhage and an intracerebral hemorrhage?
A
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2
Q

Stroke

  • What is the definition of a stroke?
  • What percentage of strokes are ischemic?
  • What percentage of strokes are hemorrhagic?
    • What are the 2 kinds of intraparenchymal hemorrhages?
    • What is the most common non-intraparenchymal hemorrhage?
A
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3
Q

What is shown here?

A
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4
Q

Typical Locations of Intracerebral hemorrhages

  • Hypertensive ICH’s commonly occur in the:
    1. Putamen
    2. Thalamus
    3. Subcortical white matter
    4. Pons
    5. and Cerebellum .
    6. They can also present as lobar hemorrhages.

Which common ICH is shown?

A

Putamen

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5
Q

Typical Locations of Intracerebral hemorrhages

  • Hypertensive ICH’s commonly occur in the:
    1. Putamen
    2. Thalamus
    3. Subcortical white matter
    4. Pons
    5. and Cerebellum .
    6. They can also present as lobar hemorrhages.

Which common ICH is shown?

A

Thalamus

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6
Q

Typical Locations of Intracerebral hemorrhages

  • Hypertensive ICH’s commonly occur in the:
    1. Putamen
    2. Thalamus
    3. Subcortical white matter
    4. Pons
    5. and Cerebellum .
    6. They can also present as lobar hemorrhages.

Which common ICH is shown?

A

Subcortical white matter

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7
Q

Typical Locations of Intracerebral hemorrhages

  • Hypertensive ICH’s commonly occur in the:
    1. Putamen
    2. Thalamus
    3. Subcortical white matter
    4. Pons
    5. and Cerebellum .
    6. They can also present as lobar hemorrhages.

Which common ICH is shown?

A

Pons

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8
Q

Typical Locations of Intracerebral hemorrhages

  • Hypertensive ICH’s commonly occur in the:
    1. Putamen
    2. Thalamus
    3. Subcortical white matter
    4. Pons
    5. and Cerebellum .
    6. They can also present as lobar hemorrhages.

Which common ICH is shown?

A

Cerebellum

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9
Q

Typical Locations of Intracerebral hemorrhages

  • Hypertensive ICH’s commonly occur in the:
    1. Putamen
    2. Thalamus
    3. Subcortical white matter
    4. Pons
    5. and Cerebellum .
    6. They can also present as lobar hemorrhages.

Which common ICH is shown?

A

lobar hemorrhage

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10
Q

Typical Locations of Intracerebral hemorrhages

  • Hypertensive ICH’s commonly occur in the:
    • Putamen
    • Thalamus
    • Subcortical white matter
    • Pons
    • and Cerebellum .
    • They can also present as lobar hemorrhages.
  • Which 2 locations often extend into ventricles?
  • What are the 3 common causes of lobar hemorrhages?
A
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11
Q

Morbidity and Mortality of Intracerebral Hemorrhage

  • What is the 2-day mortality rate?
  • What is the 30-day mortality rate?
  • How many patients live past 6 months?
A
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12
Q

Underlying Conditions for ICH

  • HTN
    • What does this do the walls of small/medium penetrating vessels?
    • Where in the brain is this most likely to occur? (4)
A
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13
Q

Underlying Conditions for ICH

  • Cerebral Amyloid Angiopathy
    • What kind of hemorrhage is this the most common cause of?
    • Does this affect deep or superficial brain tissues?
    • What does the amyloid deposition do to the vessels? (5)
A
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14
Q

Underlying Conditions for ICH

  • Other causes of NON-Traumatic ICH
    • What are 3 causes of ICH, aside from HTN and Amyloid deposition? (3)
      • (Not Risk Factors)
A
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15
Q

Risk Factors for ICH

  • What are 3 common risk factors for stroke, aside from HTN and amyloid deposition?
A
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16
Q

ICH Presentation

  • What kind of activity do these occur with?
  • What is notable about the onset and severity of signs/symptoms?
  • Why do HA and vomiting occur? How common is this?
  • What can blood leaking into the CSF lead to?
  • What kind of hemorrhage is associated with vertigo and balance issues?
A
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17
Q

Pathophysiology of ICH

  • What actually causes the direct mechanical injury to the brain parenchymal?
A
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18
Q

Underlying Conditions for ICH

  • Hematoma
    • What happens over the first 24 hours after this forms?
    • What does perihematoma edema develop?
      • When does this edema peak?
A
19
Q

Diagnostic Workup for ICH

  • What 2 types of CT’s should you run?
    • What are you looking for aside from a hematoma?
  • What kind of labs should you run? (3)
A
20
Q

Tx of ICH

  • What is the first thing you do in all emergency situations? (The AB of ABCDE)
A
21
Q

Tx of ICH

  • After the airway and breathing have been assessed, what do things need to be checked/treated? (Related to the C in ABCDE)
    • Just state what needs to be done, do not explain how to do it yet
A

Circulation: Anti-Coagulation Tx and BP control

22
Q

Tx of ICH: Reverse Coagulopathy

  • What 4 drugs can be considered?
  • What is idarucizumab?
  • How do you treat thrombocytopenia
A
23
Q

Tx of ICH: BP Control

  • What do many PTs with ICH have?
  • What do you want to get a patients systolic BP to?
  • Does this change the neurologic outcome?
  • What 3 drugs can be administered?
A
24
Q

Tx of ICH: Seizures

  • If an ICH has a seizure, what drug do you use to STOP the seizure and at what dosage?
    • What drug follows this and what dose do you give?
    • What must you be ready to do?
A
25
Q

ICH: Mechanisms of Brain Injury

  • What causes mechanical brain injury?
  • What does increased brain edema lead to? (3)
A
26
Q

ICH and Tx to minimize Secondary Brain Injury

  • What are the goals of this treatment? (2)
  • What is CPP?
A
27
Q

Cerebellar Hemorrhages

  • What symptoms do patients present with? (5)
  • Do they have a negative or positive HINTS test?
  • What is notable about the posterior fossa that causes an increased risk for rapid deterioration of a patients condition?
  • When is surgery indicated?
A
28
Q

Vertebral Artery Dissection

  • What kind of stroke does this present as?
  • How does this relate to age and activity during the stroke?
  • Why do these occur?
A
29
Q

What is this?

A

Subarachnoid Hemorrhage

30
Q

Subarachnoid Hemorrhages

  • What happens in about 1/3 of these cases?
    • When does it occur?
    • Where does blood go?
  • How do patients present’?
A
31
Q

Subarachnoid Hemorrhages

  • Where do about 90% of saccular aneurysms occur?
  • How do AVMs relate to this?
A
32
Q

Subarachnoid Hemorrhages

  • What is notable about the headache?
  • What other symptoms can the patient present with?
  • What disease is associated with this?
  • How do genetics relate to this?
  • How do unruptured expanding aneurysms present?
A
33
Q

Subarachnoid Hemorrhages: Dx

  • What is the initial test conducted?
    • How sensitive is this?
    • What does the sensitivity decrease?
A
34
Q

Subarachnoid Hemorrhages: Dx

  • How many samples do you collect, and at what volume?
  • What do you do with these samples?
  • What are the 2 things that will indicate a positive test?
A
35
Q

Subarachnoid Hemorrhages: Dx

  • Lumbar Puncture and Xanthochromia
    • Where are these present in CSF?
    • What does it breakdown?
    • How do you inspect for this?
A
36
Q

Subarachnoid Hemorrhages: Dx

  • What kind of imaging is this?
  • What is at the yellow arrow?
A
37
Q

Subarachnoid Hemorrhage: Pathophysiology

  • What is notable about the mortality rate for this?
  • Complications
    • What does ischemia cause?
    • Why does vasospasm occur?
      • What do you use to treat vasospasm?
    • What other complications exist?
A
38
Q

Surgical Tx for Aneurysms

  • What 2 treatments are performed?
A
39
Q

Traumatic Subarachnoid Hemorrhage

  • What are these usually associated with?
  • Why is there no vasospasm?
A
40
Q

Subarachnoid Hemorrhage

  • Pitfalls
    • Why is there a high rate of misdiagnosis at the intial presentation? (2)
A
41
Q

AVMs

  • When do these form?
  • What do these appear as?
  • What are these best seen with?
  • What do these present as with?
  • What kind of hemorrhages are commonly associated with this?
A
42
Q

What is shown here?

A
43
Q
A

Neuro - Post Midterm (29 decks)

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