haemorrhagic stroke

Question 1

pathophysiology of haemorrhagic stroke (6)

Answer 1

The expanding blood clot dissects and destroys brain
tissue
 It acts like space-occupying lesion causing high
intracranial pressure
 High ICP may affect cerebral perfusion
 High ICP in one compartment may displace structures and
cause herniation
 Brain stem compression cause death
 Mortality is high in hemorrhage

Question 2

signs and symptoms of increased ICP 5

Answer 2

headache
seizure
n/v
AMS
photophobia and diplobia/ blurring of vision

Question 3

what is ICH, where does it usually occur?

Answer 3

Bleeding occurs in the brain substance
 It usually from small arteries deep in the white
matter
 Common sites: basal ganglia,thalamus, pons and
cerebellum

Question 4

clinical features of haemorrhagic stroke (3)

Answer 4

 Stroke usually occurs while the patient is awake or exerting
 Sudden onset within minutes
 Often associated with severe headache and vomiting. Seizures
are common

Question 5

what are the complications of haemorrhagic stroke?

Answer 5

 Vasospasm: Presence of blood may irritate one or more arteries
causing vasospasm and ischemia within 1 or 2 weeks
 Hydrocephalus: Blockage of reabsorption of CSF can result in
hydrocephalus and increase in ICP
 Rerupture: chances are higher

Question 6

symptoms of ganglionic haemorrhage

Answer 6

Contralateral hemiplegia which worsens to drowsiness and
coma

Question 7

symptoms of thalamic haemorrhage

Answer 7

Contralateral hemiplegia with involvement of third nerve

Question 8

symptoms of pontine haemorrhage

Answer 8

Quadriplegia, pin-point pupils, death

Question 9

symptoms of cerebellar haemorrhage

Answer 9

Ataxia, altered sensorium, death

Question 10

cause of SAH

Answer 10

Subarchnoid hemorhhage
 Commonly due to saccular aneurysms of cerebral arteries

Question 11

what is saccular aneurysm

Answer 11

Saccular aneurysms (Berry aneurysm)
 Congenital pouch-like dilatations of the arterial wall.
 Rupture of the dome occurs in adolescents

Question 12

Clinical Features of SAH

Answer 12

 Sudden onset of worst
headache ever
experienced
 Vomiting
 May or may not lose
consciousness
 commonly no focal
neurological deficits