Haemorrhages

Question 1

What is a subarachnoid haemorrhage?

Answer 1

Bleeding me to subarachnoid space

Question 2

What usually causes subarachnoid haemorrhage ?

Answer 2

Usually underlying berry aneurysm

Question 3

Symptoms of subarachnoid haemorrhage ?

Answer 3

Sudden severe headache
Collapse
Vomiting
Neck pain 
Photophobia

Question 4

Signs of subarachnoid haemorrhage?

Answer 4

Decreased conscious levels
Focal neurological deficit
Fundoscopy - retinal/ vitreous haemorrhage

Question 5

Complications of subarachnoid haemorrhage ?

Answer 5

Re-bleeding
Delayed ischaemic deficit 
Hydrocephalus
Hyponatraemia
Seizures

Question 6

Investigations for subarachnoid haemorrhage?

Answer 6

CT
Lumbar puncture
Cerebral angiography

Question 7

Management of subarachnoid haemorrhages?

Answer 7

Keep hydrated to maintain cerebral perfusion
Nimodipine
Surgical clipping
Intracranial stents / balloon remodelling
Hyrocephalus - VP shunt

Question 8

Prognosis for subarachnoid haemorrhage?

Answer 8

50% die in first month

Question 9

What is an intracranial haemorrhage?

Answer 9

Bleeding into the brain parenchyma

Question 10

Causes of intracranial haemorrhages?

Answer 10

Hypertension

Aneurysm / arteriovenous malformation

Question 11

Presentation of intracranial haemorrhage?

Answer 11

Headache
Focal neurological deficit
Decreased conscious level

Question 12

Investigations for intracranial haemorrhage?

Answer 12

CT

Angiography

Question 13

Treatment of intracranial haemorrhage?

Answer 13

Surgical evacuation of haematoma +/- treatment of underlying abnormality

Question 14

What is a intraventricular haemorrhage ?

Answer 14

Rupture of a subarachnoid or intercerebral bleed into a ventricle

Question 15

What is a subdural haemorrhage?

Answer 15

Bleeding between the arachnoid and dura mater

Question 16

Most likely cause of subdural haemorrhage ?

Answer 16

Trauma

Question 17

What does subdural haemorrhage look like of CT/MRI?

Answer 17

Clots and a midline shift

Question 18

Does ICP increase or decrease in subdural haemorrhage?

Answer 18

Increase

Question 19

Treatment of subdural haemorrhage ?

Answer 19

Irrigation/ evacuation

Craniotomy - 2nd line

Question 20

What is an extradural haemorrhage?

Answer 20

Bleed between the bone and the dura

Question 21

Potential cause of extradural haemorrhage?

Answer 21

Fracture in temporal parietal bone causing laceration of Middle meningeal artery / vein

Question 22

Does extradural haemorrhage cause increase or decrease in ICP?

Answer 22

Increase

Question 23

Treatment of extradural haemorrhage?

Answer 23

Neurosurgery for clot evacuation and ligation of bleeding