Intracerebral Haemorrhage Flashcards

1
Q

What proportion of strokes are haemorrhagic?

A

15%

  • Intracerebral haemorrhage (10%)
  • Sub-arachnoid haemorrhage (5%)
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2
Q

What are the two main types of haemorrhagic stroke?

A

Deep intra-cerebral haemorrhage

Lobar intra-cerebral haemorrhage

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3
Q

Describe a deep intra-cerebral haemorrhage

A

Caused by rupture of micro-aneurysms (Charcot-Bouchard)

Occur in sub-cortical areas

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4
Q

Describe a lobar intra-cerebral haemorrhage

A

Occur in normotensive individuals >60 in cerebral cortex

Can be caused by cerebral amyloid angiopathy

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5
Q

What is the presentation of an intracerebral haemorrhage?

A

Same as haemorrhagic stroke
No reliable way to differentiate at bedside
-more likely to present w/ severe headache & coma

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6
Q

What investigations are appropriate in suspected intracerebral haemorrhage?

A

CT (haemorrhage seen immediately)

MRI (reliable >2hrs from sx onset)

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7
Q

What is the appropriate management of intracerebral haemorrhage?

A

As per cerebral infarction (antiplatelets/anticoag contraindicated)
Reverse anticoag
Lower BP to <140/90 w/i 1hr (IV betolol)
Neurosurgical intervention

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8
Q

What is the immediate prognosis of intracerebral haemorrhage?

A

Worse than ischaemic stroke

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