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Year 3 - Neuro > Intracerebral and Intracranial Bleeds > Flashcards

Intracerebral and Intracranial Bleeds Flashcards

1
Q

Where is an extra dural haemorrhage?

A

Between dura and bone

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2
Q

What is the commonest cause of extra-dural haemorrhage?

A

Skull fracture at the pterion

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3
Q

Which artery is most commonly damaged in extra-dural haemorrhage?

A

MCA

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4
Q

Describe the classic presentation of an extra-dural haemorrhage

A 
Fall, transient loss of consciousness 
ICP increase symptoms
Low level consciousness
Ipsilateral dilated pupil
Hemiparesis
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5
Q

How is an extra-dural haemorrhage investigated?

A

CT - hyperdense, biconvex bleed limited to suture lines

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6
Q

How is an extradural haemorrhage managed?

A

Immediate evacuation

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7
Q

What is given to a patient with extra-dural haemorrhage whilst waiting for surgery?

A

Mannitol and hyperventilation

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8
Q

Where is the bleed in a subdural haematoma?

A

Between dura and arachnoid

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9
Q

What structure is damaged (mostly) in subdural haematoma?

A

Bridging veins

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10
Q

What is the common presentation of a subdural haematoma?

A

Elderly alcoholic patient presents after a fall

Unconscious

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11
Q

What drug therapy is associated with a risk of subdural haematoma?

A

Warfarin

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12
Q

A subdural haematoma that presents after 2 days is classified as….

A

Acute

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13
Q

How does an acute subdural look on CT?

A

Hyperdense

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14
Q

A subdural haematoma that presents after 7 days is classified as….

A

Subacute

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15
Q

How does an acute subdural haemorrhage look on CT?

A

Isodense

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16
Q

A subdural haematoma that presents after 22 days is classified as….

A

Chronic

17
Q

What shape is a subdural haematoma on CT?

A

Crescent shaped, crosses suture lines

18
Q

Give 4 risk factors or chronic subdural haematoma

A

Alcohol abuse
Anticoag use
Abnormal coag
Falls

19
Q

How is a subdural haemorrhage managed?

A

Evacuate if >10mm or >5mm but causes midline shift

20
Q

What is the pathophysiology of a chronic subdural haemorrhage?

A

Blood from subdural haemorrhage broken down to produce a “motor-oil like” fluid which does not clot
It attracts water
Volume of haematoma/fluid collection then increased

21
Q

How does a chronic subdural haematoma present?

A

Features of raised ICP without neuro deficit

22
Q

What does a CT scan on subdural haematoma show?

A

Hypodense, crescent shaped mass over the hemisphere

Midline shift

23
Q

What is a subarachnoid haemorrhage?

A

Bleed into the subarachnoid space

24
Q

What is the most common cause of a subarachnoid haemorrhage?

A

Berry aneurysm

25
Q

How does a subarachnoid haemorrhage present?

A

Sudden onset severe headache coming on during a period of exertion
Features of meningitis

26
Q

How is a subarachnoid haemorrhage investigated?

A

CT showing hyperdense SA space

27
Q

How is a subarachnoid haemorrhage managed?

A

Endovascular clip or coil
Give CCBs to prevent vasospasm
Analgesia

Year 3 - Neuro (19 decks)

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