Haemorrhages

Question 1

Meninges layers

Answer 1

Pis matter
Arachnoid matter
Dura matter

Question 2

Vessels of meninges

Answer 2

Extradural -middle meningeal artery
Subdural - bridging veins
Subarachnoid - circle of Willis
Pia - no vessels as forms part of blood-brain barrier

Question 3

Types of haemorrhage and where they are

Answer 3

Intracerebral -within brain parenchyma
Subarachnoid- arachnoid and pia
Subdural -arachnoid and dura
Extradural skull and dura

Question 4

Intracerebral haemorrhage what it is what it causes and CT shows

Answer 4

Within brain parenchyma
Haemorrhaging stroke
Causes sudden onset neurological deficits

Shows as hyper-attention in brain parenchyma on a CT scan

Question 5

Subarachnoid haemorrhage what it is why and ct scan

Answer 5

Rupture of a berry aneurysm
Cause by trauma, rupture
Thunderclap headache
Sudden onset

Ct- hyper attenuation around circle of wills

Question 6

Subdural

What it is what causes and CT scan

Answer 6

Rupture of bridging cranial veins
Caused by: trauma , alcohol misuse, older
Causes gradual deterioration

Ct- concave/crescent

Question 7

Extradural

Answer 7

Rupture of middle meningeal artery in temporal surface of skull

Skull trauma/fracture

Lucid intervals followed by unconsciousness

Convex shape -lemon

Question 8

Treatment for subarachnoid

Answer 8

50% die in hospital
Bed rest
Calcium channel blockers nimodipine
Supportive measures for hypertension
IV saline to replace salts
Dexamethasone for cerebral oedema

Question 9

Treatment for Subdural

Answer 9

Surgical removal of haematoma

Mannitol reduce ICP in small doses

Question 10

Treatment for Extradural

Answer 10

Surgical drainage

Mannitol reduce ICP in small doses

Question 11

Signs of a subarachnoid

Answer 11

Kernigs sign unable to extend patients leg at knee when thigh flexed
Neck stiffness
Brudzinskis sign when neck flexed patient will flex hips and knees