Avc Hemorrágico

Question 1

What is an intraparenchymal cerebral hemorrhage?

Answer 1

An intracerebral hemorrhage, or intraparenchymal cerebral hemorrhage, is a subset of an intracranial hemorrhage and encompasses a number of entities that have in common the acute accumulation of blood within the parenchyma of the brain.

Question 2

ICH are most often broadly divided according to whether they are ______________________or ________________________, and then further divided according to etiology and/or location.

Answer 2

primary hemorrhages (no underlying lesion)
secondary hemorrhages (some other lesion complicated by hemorrhage)

Question 3

Say two etiologies of primary hemorrhages (no underlying lesion)….

Answer 3

lobar hemorrhages secondary to cerebral amyloid angiopathy
hypertensive hemorrhages

Question 4

Say 3 secondary hemorrhages causes….

Answer 4

vascular malformation
cerebral venous thrombosis
tumor (primary or secondary)

Question 5

The volume of an intracerebral hemorrhage can be measured using ________________ formula or 3D volumetric software

Answer 5

ABC/2

Question 6

What is considered to be the most reliable independent predictor of ICH expansion?

Answer 6

hemorrhage size is considered to be the most reliable independent predictor of ICH expansion

Question 7

Hematoma expansion is measured as an increased growth _________ mL or volume ____________% from the initial CT scan.

Answer 7

hematoma expansion is measured as an increased growth >12.5 mL or volume >33% from the initial CT scan

Question 8

Hematomas with a volume of more than ________________ mL are more prone to expansion

Answer 8

Hematomas with a volume of more than 30 mL are more prone to expansion

Question 9

Hemorrhages with _____________shapes are more prone to expansion

Answer 9

Hemorrhages with irregular shapes are more prone to expansion

Question 10

Intracerebral hemorrhage irregularity is thought to be due to ________________________.

Answer 10

Intracerebral hemorrhage irregularity is thought to be due to multiple leaking vessels feeding the hematoma

Question 11

The presence of hypodense or isodense regions within the hyperdense intracerebral hemorrhage represents ________________ and is called _____________.

Answer 11

The presence of hypodense or isodense regions within the hyperdense intracerebral hemorrhage represents active bleeding and is called swirl sign

Question 12

What does represent the Swirl sign ?

Answer 12

It represents unclotted fresh blood which is of lower attenuation than the clotted blood which surrounds it.

Question 13

What is the name of that sign? And what is the consequence of this finding ?

Answer 13

Extradural hematoma - swirl sign.
It represents unclotted fresh blood which is of lower attenuation than the clotted blood which surrounds it.

Question 14

What is the Black hole Sign ?

Answer 14

when the swirl sign is encapsulated it is termed black hole sign.

Question 15

What is parameter to say that we have a black hole sign ?

Answer 15

There should be at least a 28 Hounsfield unit (HU) difference between the black hole and the surrounding hemorrhage

Question 16

heterogeneous hemorrhage with _________________foci is more prone to expansion

Answer 16

heterogeneous hemorrhage with hypodense foci is more prone to expansion

Question 17

Active contrast extravasation within hematoma predicts future hemorrhage expansion, this can be observed on CT angiography (CTA) as ___________________and pooling of contrast within the hematoma

Answer 17

active contrast extravasation within hematoma predicts future hemorrhage expansion, this can be observed on CT angiography (CTA) as spot sign and pooling of contrast within the hematoma

Question 18

What do i have to suspect in a patient witha a temporo-occipital haemorrhage?

Answer 18

Transverse-sigmoid sinus thrombosis

Question 19

What is the tip that may indicate an underlying tumor in the presentation?

Answer 19

Presence/absence of substantial surrounding edema that may indicate an underlying tumor

Question 20

What is the cause of this haemorrhage between gyrus rectus ?

Answer 20

Acom aneurysm

Question 21

What is the probably cause of this haemorrhage in the occipitotemporal transition?

Answer 21

Venous thrombosis

Question 22

What is the probably cause of a hamorrhage located in the sylvian fissure?

Answer 22

MCA anurysm

Question 23

What is the morphology of a metastatic haemorrhage ?

Answer 23

spherical haemorrhage