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Neurology > Brain Bleeds and Haemorrhages > Flashcards

Brain Bleeds and Haemorrhages Flashcards

1
Q

What does a subarachnoid haermorrhage involve

A

Bleeding into the subarachnoid space where the CSF is located (pia mater and archnoid mater)

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2
Q

Usual cause of subarachnoid haemorrhage

A

Ruptured cerebral aneurysm

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3
Q

History of subarachnoid haemorrhage

A

Sudden onset occipital headache that occurs during strenuous activity. ‘thunderclap headache’

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4
Q

Features of subarachnoid haemorrhage

A

Neck stiffness, photophobia, vision changes, neurological symptoms such as speech change, weakness, seizures, loss of consciousness

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5
Q

Risk factors for subarchnoid haemorrhage

A

HTN, smoking, excessive alcohol consumption, cocaine use, family history

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6
Q

What population groups are subarachnoid haemorrhages more common in

A

Black patients, females and age 45-70

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7
Q

What are subarachnoid haemorrhages particularly associated with

A

Cocaine use, sickle cell anaemia, connective tissue disorders, neurofibromatosis, autosomal dominant PCKD

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8
Q

CT scan of subarachnoid haemorrhage

A

Hyperdense area in centre of brain expanding bilaterally.

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9
Q

LP in subarachnoid haemorrhage

A

If CT is negative CSF can be tested for signs - RCC raised, xanthochromia

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10
Q

What is done to locate the source of subarachnoid haemorrhage

A

CT or MRI angiography

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11
Q

Management of subarachnoid haemorrhage

A

Surgical intervention, Nimodipine, LP and antiepileptic medications

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12
Q

Surgicaal interventions used to treat subarachnoid haemorrhage

A

Coiling or clipping

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13
Q

What does surgical coiling involve

A

Inserting a catheter into the arterial system, placing platinum coild into aneurysm and sealing it off from artery

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14
Q

What does surgical clipping involve

A

Involves cranial surgery and putting clip on the aneurysm to seal it off

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15
Q

What is the role of Nimodipine in subarachnoid haemorrhages

A

Calcium channel blocker which is used to prevent vasospasm - a common complication that can result

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16
Q

Why is an LP used in management of subarachnoid haemorrhage

A

To treat hydrocephalus

17
Q

Risk factors for intracranial bleeds

A

Head injury, HTN, aneurysms, ischaemic stroke can progress to haemorrhage, brain tumours, anticoagulants

18
Q

Types of intracranial bleeds

A

Subdural, extradural, intracerebral and subarchnoid

19
Q

Where is the bleed in subdural haemorrhage

A

Dura and arachnoid mater

20
Q

Causes of subdural haemorrhage

A

Rupture of bridging veins

21
Q

Presentation of subdural haemorrhage

A

Acute or chronic, tending to present gradually with increasing headache and confusion.

22
Q

Who are subdural haemorrhages more likely to occur in

A

Elderly patients and alcoholic due to atrophy in brain

23
Q

Causes of subdural haemorrhage

A

History of trauma, alcohlism and anticoagulation, accerlation-deceraltion injury

24
Q

What does subdural haemorrhage look like on CT

A

Crescent shape, following contours of skull as it is not limited by cranial sutures

25
Q

Difference between acute and chronic subdural haemorrhage on CT

A

Hyperdense is acute, and hypodense is chronic

26
Q

Where is the bleed in an extradural haemorrhage

A

Skull and dura mater

27
Q

Cause of extradural haemorrhage

A

Trauma to pterion, associated with fracture to temporal bone

28
Q

Which vessels bleeds in extra dural haemorrhage

A

Middle meningeal artery

29
Q

History of extradural haemorrhage

A

Young patient with traumatic head injury that has ongoing headache. Period of improved symptoms and consciousness followed by rapid decline as haematoma compresses intracranial contents

30
Q

Symptoms of extradural haemorrhage

A

Acute severe headache, loss of consciousness, lucid interval then rapid deterioration

31
Q

CT image of extradural haemorrhage

A

Hyperdense bioconvex shape limited by cranial sutures

32
Q

Where is an intracerebral haemorrhage

A

Bleeding into the brain tissue

33
Q

Presentation of intracerebral haemorrhage

A

Similar to ischaemic stroke

34
Q

Which areas of brain tissue can be affected

A

Lobar, deep intracerebral, intraventricular, basal ganglia and cerebellar

35
Q

Causes of intreacerebral haemorrhage

A

Spontaneously or as a result of bleeding into an ischaemic infarct or tumour or rupture of aneurysm

Neurology (21 decks)

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