Intracerebral Hemorrhage Flashcards

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1
Q

When do intracerebral hemorrhages tend to occur?

A

suddenly, without warning, during activity

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2
Q

What are intracerebral hemorrhages associated with?

A

advanced age and male sex

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3
Q

What are spontaneous, nontraumatic, intracerebral hemorrhage in patients with no angiographic evidence of an associated vascular anomaly due to?

A

hypertension

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4
Q

What is the pathologic basis for hemorrhage?

A

the presence of microaneurysms that develop on perforating vessels in hypertensive patients

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5
Q

Where do hypertensive intracerebral hemorrhages typically occur?

A

in the basal ganglia

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6
Q

What results when the hemorrhage extends into the subarachnoid space?

A

signs of meningeal irritation emerge

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7
Q

What s a frequent cause of hemorrhage in the elderly?

A

Cerebral amyloid angiopathy

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8
Q

Hemorrhage caused by cerebral amyloid angiopathy has a _____ prognosis than hypertensive hemorrhage

A

better

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9
Q

List 5 other causes of nontraumatic intracerebral hemorrhage

A
  • hematologic and bleeding disorders (leukemia, thrombocytopenia, hemophilia, or disseminated intravascular coagulation)
  • anticoagulant therapy
  • liver disease
  • high alcohol intake
  • primary or secondary brain tumors
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10
Q

Are women or men more prone to intracerebral hemorrhages

A

men

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11
Q

Where does bleeding occur primarily?

A

in the subarachnoid space when it occurs in from an intracranial aneurysm or arteriovenous malformation

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12
Q

What are the 3 general signs and symptoms of intracerebral hemorrhages?

A
  • Lost or impaired consciousness
  • Vomiting
  • Headache
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13
Q

What typically occurs with hypertensive hemorrhage?

A

a rapidly evolving neurologic deficit with hemiplegia or hemiparesis

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14
Q

What do cerebellar hemorrhages present as?

A
  • sudden onset of nausea and vomiting
  • dysequilibrium
  • headache
  • loss of consciousness that may terminate fatally within 48 hours
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15
Q

What imaging modality is the best at detecting intracranial hemorrhage less than 48 hours old?

A

CT without contrast

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16
Q

What image finding is a predictor of poor outcome?

A

hematoma expansion

17
Q

What lab values may reveal a predisposing cause for hemorrhage?

A
  • complete blood count
  • platelet count
  • bleeding time
  • prothrombin and partial thromboplastin times
  • liver and kidney function tests
18
Q

What special test is contraindicated and why?

A

Lumbar puncture because it may precipitate a herniation syndrome in patients with a large hematoma

19
Q

Treatment for intracranial hemorrhage is typically _____ and ______.

A

conservative and supportive

20
Q

Describe treatment options

A
  • ventilatory support
  • blood pressure regulation
  • seizure prophylaxis
  • control of fever
  • osmotherapy
  • nutritional supplementation
21
Q

What may be required in patients with intraventricular hemorrhage and acute hydrocephalus?

A

ventricular drainage

22
Q

What is the treatment protocol for cerebellar hemorrhages?

A

prompt surgical evacuation of the hematoma