epilepsy management

Question 1

What is a Subarachnoid haemorrhage?

Answer 1

bleeding into the subarachnoid space

Question 2

What is the most common cause of subarachnoid haemorrhage

Answer 2

Berry aneurysm

Question 3

Where is the commonest site of Berry aneurysms?

Answer 3

bifurcations of verses (carotid)

Question 4

What are the common clinical features of SAH?

Answer 4

sudden onset severe headache 
collapse
vomiting 
neck pain 
photophobia

Question 5

What is benign coital cephalgia?

Answer 5

sudden onset headache while having sex

Question 6

What is seen on brain CT that indicates blood?

Answer 6

white in the normally black ventricles

Question 7

What can be seen in a patient with SAH in their CSF?

Answer 7

xanthochromia

Question 8

How is xanthocromia differentiated from a traumatic tap

Answer 8

multiple bottles

Question 9

What is the gold standard for diagnosing aneurysms?

Answer 9

cerebral angiography - MR/CT

Question 10

What causes delayed ischaemic deficit in SAH?

Answer 10

blood vessel vasospasm thus causing ischaemia

Question 11

What are some complications of SAH?

Answer 11

re-bleeding 
DID 
hydrocephalus 
hyponatraemia 
seizures

Question 12

what are the treatment options for SAH?

Answer 12

clipping
coiling
embolisation

Question 13

When does delayed ischaemic deficit tend to occur?

Answer 13

day 3-12

Question 14

What medication is given to prevent/treat DID?

Answer 14

nimodipine

Question 15

What is Triple H therapy?

Answer 15

hypervolaemia
hypertension
haemodilution

dehydration predisposes to cerebral ischaemia

Question 16

How is hydrocephalus treated?

Answer 16

CSF drainage - LP, EVD, Shunt

Question 17

What is intracerebral haemorrhage?

Answer 17

bleeding into the brain parenchyma

Question 18

What is the most common cause of intracerebral haemorrhage?

Answer 18

hypertension

Question 19

How does ICH present?

Answer 19

headache
focal neurological deficit
reduced consciousness level

Question 20

How are ICH investigated?

Answer 20

CT

angiography if vascular anomaly suspected

Question 21

How are ICHs treated?

Answer 21

surgical evacuation of haematoma

treat underlying cause

Question 22

What is an intraventricular haemorrhage?

Answer 22

rupture of a Subarachnoid or intracerebral bleed into a ventricle

Question 23

How are AVMs treated?

Answer 23

surgery
embolisation
radiotherapy
conservative

Question 24

how does embolisation help in AVM treatment

Answer 24

removes some of the problem to make surgery easier