Aneurysms, Hemorrhages, and Hematomas Flashcards
a weak spot in an artery that can rupture with any force, leading to a hemorrhage
cerebral aneurysm
what is the clinical presentation of an aneurysm?
asymptomatic until rupture
what is the probability of aneurysm rupture related to?
the size of the aneurysm
what is most commonly identified with screening and has a low risk for rupture?
small aneurysm less than 6 mm in diameter
patients with ruptured aneurysms less than ____ mm have a better prognosis
10
in which case is screening for a cerebral aneurysm necessary?
what screening will be done?
family history in two 1st degree relatives
CTA head or MRA head at 20 yo + every 5-10 years
incidental aneurysm are treated at which diameter?
over 7-10 mm
in which 5 instances would an incidental aneurysm especially be treated?
posterior circulation aneurysm
+ daughter sac (weak point)
young age
hx of SAH
family hx of SAH
what are 2 treatment options for a cerebral aneurysm?
clipping
coiling
what are most SAH caused by?
ruptured aneurysm
a patient presents with a “thunderclap” headache and they say its the worst headache of their life. they have meningismus/stiff neck, photophobia, N/V, and loss of consciousness. what are they experiencing?
subarachnoid hemorrhage
what diagnostic would we use for a subarachnoid hemorrhage?
how would it look?
CT head without contrast
white = blood
what diagnostic can be done if a head CT without contrast is negative but we still suspect SAH?
LP
what is the management of a SAH? (2)
treat aneurysm by neurosx
lower BP
what is the goal for BP in a patient with SAH?
systolic BP < 160
what would be given to prevent a vasospasm and delayed ischemia in a patient with a SAH? (3)
transcranial doppler
nimodipine x 21 days
statins while in ICU
what 2 conditions would we want to avoid in a patient with a SAH?
hyperthermia
hyperglycemia
how should a patient with a SAH be placed to reduce ICP?
head elevated at 30
ruptured vein that runs between the dura and cortex of brain tissue
subdural hematoma
what is a subdural hematoma commonly caused by?
head trauma
a patient presents with headache, confusion, irritability, and papilledema. what are they experiencing?
subdural hematoma
what diagnostic should be done for a patient with suspicious subdural hematoma?
CT head without contrast
what is the management/treatment for a subdural hematoma? (4)
neurosx consult
mannitol to lower ICP
head elevation at 30
fix any coagulopathy
bleeding between the dura mater and the skill, what is usually associated with ruptured arteries
epidural hematoma
