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J Neuro > Haemorrhage > Flashcards

Haemorrhage Flashcards

1
Q

risk factors for haemorrhage (6)

A 
congenital malformation 
hypertension 
systemic anti coagulation (eg on warfarin) 
trauma 
amyloid deposits 
vasculitis
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2
Q

where are extradural haemorrhages

A

between the bone and dura

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3
Q

aetiology of extradural haemorrhages

A

head trauma (sporting injuries)

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4
Q

which part of the skull is usually fractured in extra dural haemorrhages

which vessel does this cause to haemorrhage

A

pterion

middle meningeal artery

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5
Q

how does extradural haemorrhage present after trauma

A

loss of consciousness
headache
vomiting

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6
Q

what investigation should you do after any head trauma

A

CT

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7
Q

what shape does a extradural haemorrhage look like on CT

A

convex lens

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8
Q

what can happen to the rest of the brain after an extradural haemorrhage (seen on CT)

A

midline shift/herniation

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9
Q

management of extradural haemorrhage

A

SUGRERY asap

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10
Q

where is the bleed in a subdural haemorrhage

A

between the dura and arachnoid mater

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11
Q

which vessels are rupture in a subdural haemorrhage

A

cerebral bridging veins

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12
Q

who presents with subdural haemorrhages

A

elderly/alcoholics after falls

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13
Q

presentation of subdural haemorrhage

A 
slow/chronic onset 
headache 
confusion 
urinary incontinence 
weakness
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14
Q

what shape does a subdural haemorrhage look like on CT

A

crescent shaped (moon)

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15
Q

what colour is fresh blood on brain CT

A

white

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16
Q

management of subdural haemorhrage

A

surgery asap

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17
Q

where is a subarachnoid haemorrhage at

A

between arachnoid and pia mater

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18
Q

3 main causes of subarachnoid haemorrhage

A 
severe trauma (worse than extradural haemorrhage)
circle of willis aneurysm eg berry aneurysm (complication of PKD) 
congenital aneurysm (AVM - arteriovenous malformation)
19
Q

which vessel is affected in a berry aneurysm

A

circle of willis

20
Q

which part of the circle of willis is most susceptible to aneurysms

A

bifurcation of internal carotid

21
Q

why does subarachoid haemorrhage present like meningitis

A

blood aggravates the dura (like meningitis)

22
Q

presentation of subarachnoid haemorrhage

A 
thunderclap headache for 1 hour - worst headache ever 
neck stiffness 
photophobia 
vomiting 
oss of consciousness
23
Q

what is sudden onset headache during sex (just before climax) called

what should be your top differential if you suspect this

A

benign coital cephalgia

SUBARACHNOID HAEMORRHAGE!

24
Q

when doesn’t CT pick up a haemorrhage

A

if not acute presentation

blood has absorbed into brain tissue

25
Q

investigation for subarachnoid haemorrhage (3)

A

CT - looking for white around circle of willis etc
lumbar puncture
CT angiography

26
Q

what would you expect to see in lumbar puncture sample if subarachnoid haemorrhage

A

xanthochromic (yellow CSF)

27
Q

what is it called when there is fresh blood in the CSF sample from lumbar puncture

A

traumatic tap (just pinched a blood vessel when doing LP)

28
Q

which investigation is GOLD standard for subarachnoid haemorrhage

why isn’t CT

A

lumbar puncture

bc CT only picks up fresh haemorhrage

29
Q

what is the DIAGNOSTIC investigation done for subarachnoid haemorrhages

A

CT angiography

to find the source of bleeding

30
Q

management of subarachnoid haemorrhage

why don’t you need to remove the blood

A

symptomatic - bed rest, hydration
curative - surgery (coil or clip)

blood is reabsorbed into CSF itself, only need to stop the bleeding don’t need to get rid of blood

31
Q

patient had subarachnoid bleed 1 week ago
now has altered consciousness

what complication does he have

A

vasospasm = delayed ischemia

32
Q

what happens if you don’t coil/clip the bleeding artery

A

rebleed

33
Q

after subarachnoid haemorrhage, blood is reabsorbed into CSF

how does this affect the patient

how do you treat this

A

transient headache

nothing, just warn them it will happen

34
Q

brain herniation through foramen magnum causes…

A

cushings triad
- low HR, irregular RR, extreme hypertension

FATAL

35
Q

how many people die on the spot of subarachnoid haemorrhage

how mnay people die after a months of subarachnoid haemorrhage

A

10%

50%

36
Q

what is another name for an intracerebral hameorhrage

A

hemorrhagic stroke (See stroke flashcards)

37
Q

are arteriovenous malformations (AVM) congenital or acquired

A

congenital

38
Q

why are AVM serious

A

can haemorrhage (intracerebral, subarachnoid or subdural)

39
Q

treatment of AVM

A

surgery to remove

embolization/coil to stop bleed

40
Q

investigation for AVM

A

catheter angiography - see a tangle of vessels

41
Q

‘popcorn like’ appearance on brain MRI

cause of haemorrhage

A

cavernous malformation

42
Q

which type of circle of willis aneurysm is associated with polycyctic kidney disease (PKD)

A

berry aneurysm

43
Q

apart from PKD, what other condition is associated with brain aneurysms

A

ehlers danlos

bc aneurysms are a problem with the elasticity of blood vessel membrane

J Neuro (32 decks)

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