Intracranial Bleeds

Question 1

AETIOLOGY

Risk factor

Answer 1

• Head injury
• Hypertension
• Aneurysms
• Ischaemic stroke
• Brain tumours
• Anticoagulants such as warfarin

Question 2

CLINICAL FEATURES

Presentation

Answer 2

• Sudden onset headache - key feature
• Seizures
• Weakness
• Vomiting
• Reduced consciousness
• Other sudden onset neurological symptoms

Question 3

MANAGEMENT

General principles

Answer 3

• Immediate CT to establish diagnosis
• Check FBC and clotting
• Admit to specialist stroke uni
• Consider intubation, ventilation and ICU
• Correct any clotting abnormality
• Correct severe hypertension but avoid hypotension

Question 4

Types

Answer 4

• Subdural haemmorhage
• Extradural haemorrhage
• Intracerebral haermorrhage
• Subarachnoid haemorrhage

Question 5

Examples of intracerebral haemorhage

Answer 5

• Bleeding into brain tissue, presents similar to ischaemic stroke
  
  • Lobar intracerebral haemorrhage
  • Deep intracerebral haemorrhage
  • Intraventricular haemorrhage
  • Basal ganglia haemorrhage
  • Cerebellar haemorrhage