Exam 3 Cerebrovascular Dz Hemorrhages

Question 1

Intracerebral Hemorrhage (ICH) risk factors? (4)

Answer 1

Uncontrolled HTN
Coag defects
Anticoag therapy
Recreational drug use

Question 2

ICH common sites? (3)

Answer 2

Basal ganglia
Pons
Cerebellum

Question 3

ICH presentation? (4)

Answer 3

Acute onset of:
Severe HA
N/V
↑↑ BP
Focal neuro defects

Question 4

ICH imaging? (2)

Answer 4

CT

MRI (for small lesions)

Question 5

ICH tx? (4)

Answer 5

Control BP
Anticonvulsants
Control ICP
Decompression to ↓ mass effect

Question 6

Arteriovenous Malformations are?

Presentation?

Answer 6

Congenital vascular malforms

Bleeding into or on surface of brain, seizures

Question 7

Subarachnoid Hemorrhage (SAH) a/w? (3)

Answer 7

Congenital berry aneurysms
Arteriovenous malform
Trauma

Question 8

SAH presentation? (5)

Answer 8

Acute onset of:

Worst headache of life
N/V
Mental ∆
Nuchal rigidity
Focal neuro defects

Question 9

SAH imaging? (3)

Answer 9

CT w/o contrast
Lumbar puncture if CT unclear
Angio

Question 10

Hunt/Hess classification of SAH

Grade I?

Grade II?

Grade II?

Grade IV?

Grade V?

Answer 10

I = asymp, mild HA

II = Mod-sever HA w/ or w/o CN palsies, nuchal rigidity

III = Drowsy, confused w/ focal deficits

IV = Stupor, severe deficits, early decorticate posturing

V = Comatose, decerebrate posturing

Question 11

SAH mgmt? (6)

Answer 11

Control BP
Nimodipine (vasospasm prophy)
Osmotic diuresis (↓ ICP)
Ventriculostomy ( ↓ ICP)
Phenytoin (seizure prophy)
Neurosurgery

Question 12

SAH complications? (4)

Answer 12

Re-bleed
Vasospasm
CVA
Hydrocephalus

Question 13

Cincinnati Pre-hospital Stroke Scale? (3)

Answer 13

One-sided facial droop
One-sided arm drift
Slurred/inapprop/mute speech