Brain haemorrhage: Flashcards
Into what space do subarachnoid Haemorrhages bleed into?
Subarachnoid space
What is the most common cause of subarachnoid haemorrhage?
Rupture of berry aneurysms in the circle of Willis and its branches
What are the features of a subarachnoid haemorrhage?
- Sudden onset headache (thunderclap)
- Nausea/vomiting
- Reduced consciousness
- Meningeal irritation (neck stiffness, Kernigs sign positive)
What investigations should be performed in someone with a suspected SAH?
- CT head - blood in SA space (star sign)
- LP if CT normal but SAH suspected - xanthochromia
- MR angiography to identify aneurysm
After what period of time does xanthochromia develop?
After 12hrs
What is the management for SAH?
- Bed rest, analgesia, supportive
- Nimodipine (CCB) prevents cerebral artery spasm
What is a subdural haematoma (SDH)?
Accumulation of blood in the subdural space following rupture of veins running from hemisphere to sagittal sinus (mid-line).
Who are SDH usually seen in?
- Elderly
- Alcoholics
(associated with head injury)
What are the symptoms of SDH?
- Headache
- Confusion
- Fluctuating levels of consciousness
What is usually seen in minor head injury?
Chronic SDH. Latent phase.
What investigation is performed in SDH and what is the subsequent management?
- CT head is gold standard
- Surgical removal of haematoma
What is an extradural haematoma?
Collection of blood between the dura mater and skull
What is an extradural haematoma usually due to?
Rupture of middle meningeal artery following head injury - associated with temporal bone skull fracture.
What is the classical clinical picture in a EDH?
Brief period of unconsciousness followed by lucid interval of recovery.
What is seen on CT in EDH?
Biconvex haematoma
