Brain Bleeds 😨🧠

Question 1

What type of hematoma is associated with trauma and has a lens-shaped CT finding?

Answer 1

Epidural hematoma

Commonly caused by arterial bleeding from the middle meningeal artery (MMA)

Question 2

What is the common cause of subdural hematomas?

Answer 2

Venous bleeding

Typically occurs due to trauma

Question 3

What is the CT finding characteristic of a subdural hematoma?

Answer 3

Crescent-shaped

The shape indicates the nature of the bleeding between the dura and arachnoid layers

Question 4

What type of hematoma presents with blood in sulci or cisterns on a CT scan?

Answer 4

Subarachnoid hematoma

Caused by aneurysms or trauma, and has a sudden onset often described as a thunderclap headache

Question 5

What is the common cause of intracerebral hemorrhages?

Answer 5

Hypertension, amyloid, trauma

These factors contribute to localized hyperdensity on CT scans

Question 6

What is the typical onset of an epidural hematoma?

Answer 6

Rapid

This rapid onset is due to arterial bleeding

Question 7

What is the typical onset of a subdural hematoma?

Answer 7

Gradual

This gradual onset reflects the slower venous bleeding

Question 8

What CT finding is associated with intracerebral hemorrhage?

Answer 8

Localized hyperdensity

The appearance depends on the size of the hemorrhage

Question 9

Fill in the blank: A subarachnoid hematoma is typically caused by _______.

Answer 9

[Aneurysm/trauma]

Question 10

True or False: An epidural hematoma is typically venous in origin.

Answer 10

False

Epidural hematomas are typically arterial in origin

Question 11

What does the ‘E’ in the mnemonic ‘EPIC SUB for SAUCE Inside’ stand for?

Answer 11

Epidural

Refers to an epidural hematoma, which is a type of brain bleed.

Question 12

What does ‘P’ in ‘EPIC’ signify regarding epidural brain bleeds?

Answer 12

Progression (lucid interval, then rapid decline)

Indicates the typical progression of symptoms in an epidural hematoma.

Question 13

What does ‘I’ represent in the context of epidural brain bleeds?

Answer 13

Injury (trauma, middle meningeal artery)

Refers to the cause of epidural hematomas, often linked to head trauma.

Question 14

What shape do epidural hematomas appear as on a CT scan?

Answer 14

Convex (lens-shaped)

Characteristic appearance of epidural hematomas on imaging.

Question 15

What does ‘S’ in ‘SUB’ refer to in subdural brain bleeds?

Answer 15

Slow (venous bleed = gradual onset)

Indicates the gradual nature of subdural hematomas.

Question 16

Where do subdural hematomas occur in relation to the dura?

Answer 16

Underneath dura (between dura and arachnoid)

Describes the anatomical location of subdural hematomas.

Question 17

What shape do subdural hematomas have on a CT scan?

Answer 17

Banana-shaped (crescent)

Typical appearance of subdural hematomas on imaging.

Question 18

What does ‘S’ in ‘SAUCE’ signify regarding subarachnoid brain bleeds?

Answer 18

Sudden Thunderclap headache

A classic symptom of a subarachnoid hemorrhage.

Question 19

What triggers a subarachnoid hemorrhage as indicated by ‘A’ in ‘SAUCE’?

Answer 19

Aneurysm rupture

Most common cause of subarachnoid hemorrhages.

Question 20

Where does blood track in the case of subarachnoid hemorrhage, as indicated by ‘U’ in ‘SAUCE’?

Answer 20

Under sulci

Describes the location of blood in subarachnoid hemorrhage.

Question 21

What does ‘C’ in ‘SAUCE’ indicate about the CSF in subarachnoid hemorrhage?

Answer 21

Color change in CSF (xanthochromia)

A laboratory finding associated with subarachnoid hemorrhage.

Question 22

What does ‘E’ in ‘SAUCE’ indicate about the nature of subarachnoid hemorrhage?

Answer 22

Emergency!

Indicates the critical nature of a subarachnoid hemorrhage.

Question 23

What does ‘Inside’ refer to in the mnemonic?

Answer 23

Happens inside brain tissue

Refers to intracerebral hemorrhages.

Question 24

What are the key risks associated with intracerebral hemorrhage as indicated by ‘I’?

Answer 24

Intracranial pressure, Intracerebral hemorrhage, Increased hypertension risk

Highlights the complications and risks associated with intracerebral hemorrhages.

Question 25

What are the effects associated with a stroke in the anterior cerebral artery?

Answer 25

Contralateral hemiparesis and sensory loss, lower extremity > upper

This indicates that the lower limbs are more affected than the upper limbs.

Question 26

What are the effects of a middle cerebral artery stroke?

Answer 26

Contralateral hemiparesis and sensory loss, upper extremity > lower, contralateral homonymous hemianopia, aphasia

Hemiparesis and sensory loss affect the upper limbs more than the lower limbs.

Question 27

What visual impairment is associated with a posterior cerebral artery stroke?

Answer 27

Contralateral homonymous hemianopia with macular sparing, visual agnosia

Macular sparing means that the central vision remains intact despite peripheral vision loss.

Question 28

What symptoms are seen in Weber’s syndrome?

Answer 28

Ipsilateral CN III palsy, contralateral weakness of upper and lower extremity

This syndrome is associated with branches of the posterior cerebral artery that supply the midbrain.

Question 29

What are the effects of a stroke in the posterior inferior cerebellar artery?

Answer 29

Ipsilateral: facial pain and temperature loss; contralateral: limb/torso pain and temperature loss; ataxia, nystagmus

This condition is also known as lateral medullary syndrome or Wallenberg syndrome.

Question 30

What symptoms are associated with a stroke in the anterior inferior cerebellar artery?

Answer 30

Ipsilateral: facial paralysis and deafness; symptoms similar to Wallenberg’s

The anterior inferior cerebellar artery affects the cerebellum and pons.

Question 31

What is the result of a retinal/ophthalmic artery stroke?

Answer 31

Amaurosis fugax

Amaurosis fugax refers to temporary loss of vision.

Question 32

What syndrome is associated with a basilar artery stroke?

Answer 32

‘Locked-in’ syndrome

Patients are aware but unable to move or communicate due to paralysis of nearly all voluntary muscles.

Question 33

What are the common presentations of lacunar strokes?

Answer 33

Isolated hemiparesis, hemisensory loss, or hemiparesis with limb ataxia

Lacunar strokes are small strokes that occur in deep brain structures.

Question 34

What risk factor is strongly associated with lacunar strokes?

Answer 34

Hypertension

High blood pressure is a major risk factor for various types of strokes.

Question 35

What are common sites for lacunar strokes?

Answer 35

Basal ganglia, thalamus, internal capsule

These areas are frequently affected due to small vessel disease.