Haemorrhagic Stroke

Question 1

Subarachnoid and intracerebral

Answer 1

Subarachoid
Between subaracnoid and pia mater
Bleeding goes into the CSF
Thunderclap headache
Sudden loss of consciousness

Intracerebral
Symptoms based on the focal area of bleed
Decreased consciousness, headache, nausea/vomiting

Question 2

Risks

Answer 2

Could break a blood vessel

Causes
Hypertensi9n
Cocaine or other Stim
Heavy lifting
Much of the pathologyncomes from increased intracranial pressure

Question 3

Cerebral aneurysm

Answer 3

When the muscles around the artery are not strong enough to support the artery so it bulges

Causes
Hypertension, connective tissue disorders, cocaine.
May have no symptoms or headach until they burst
Most common stroke from burst aneurysm is subarachoid hemorrhagic stroke
Then Thunderclap head

Question 4

Cerebral aneurysm

Answer 4

When the muscles around the artery are not strong enough to support the artery so it bulges

Causes
Hypertension, connective tissue disorders, cocaine.
May have no symptoms or headach until they burst
Most common stroke from burst aneurysm is subarachoid hemorrhagic stroke
Then Thunderclap head

Question 5

AVM

Answer 5

A tangled mess of dila5ed blood vessels that create abnormal channels between cerebral arteries and views
Present from birth
May be asymptomatic or generic headache, seizures or reduced consciousness
More likely to rupture with hypertension or drug use

Question 6

FOCAL brain injuries

Answer 6

Blunt trauma.. meninges intact
Penetrating trauma dura mater is penetrated exposing brain

Primary focal
Contusion
Pia mater intact in a contusion
Brain contusion result from coup….forward action damage to front of brain
And
Counterculture… head bounces back and damages back of brain

Shearing forces are created

Question 7

FOCAL brain injuries

Answer 7

Blunt trauma.. meninges intact
Penetrating trauma dura mater is penetrated exposing brain

Primary focal
Contusion
Pia mater intact in a contusion
Brain contusion result from coup….forward action damage to front of brain
And
Counterculture… head bounces back and damages back of brain

Shearing forces are created

Question 8

Haematomas

Answer 8

Damage to b/vs from focal injury

Epidural hematoma…between skull and dura mater
Loss of consciousness, become lucid then deteriorate

Subdural hematoma below dura mater above arachnid mater
Headache, confusion, drowsiness, nausea vomiting

Intracerebral hematoma…in the brain itself
Symptoms depend on what part of the brain has the hematoma

Secondary injury occurs in all cases due to increasing ICP

Question 9

Diffuse axonal injury

Answer 9

Affects entire brain due to shearing
Axons cause a massive electrical storm…glutamate
Glutamate makes other neurons fire

Levels of DIA

Question 10

Brain haemodynamics

Answer 10

Skull is fixed
Head is Made of brain amd connective tissue 80%
B
Vs and blood 10%
CSF 10%
CsF is the easiest to manipulate
Brain doesn’t store much ATP or glycogen
Brain can’t do anaerobic respiration
So it must have a constant supply of blood to bringbO2 and glucose or it will start to die quickly
15 - 20% of the blood from the left ventricle goes straight to the brain

Need pressure to be 5mm Hg and 15mm Hg

Question 11

Brain haemodynamics

Answer 11

Skull is fixed
Head is Made of brain amd connective tissue 80%
B
Vs and blood 10%
CSF 10%
CsF is the easiest to manipulate
Brain doesn’t store much ATP or glycogen
Brain can’t do anaerobic respiration
So it must have a constant supply of blood to bringbO2 and glucose or it will start to die quickly
15 - 20% of the blood from the left ventricle goes straight to the brain

Need pressure to be 5mm Hg and 15mm Hg