Intracranial bleeds Flashcards
What are the four types?
- Extradural haemorrhage
- Subdural haemorrhage
- Intracerebral haemorrhage
- Subarachnoid haemorrhage
What are risk factors
Head injuries
HTN
Aneurysms
Ischaemic strokes
Brain tumours
Thrombocytopenia
Bleeding disorders
Anticoagulants
What are extradural haemorrhages associated wit?
Temporal bone fracture
How do extradural haemorrhages appear on CT?
Like an oval
dont cross cranial sutures
How do extradural haemorrhages typically present?
Traumatic head injury in young patient, period of improved neuro symptoms and consciousness with a rapid decline over hours as haematoma gets large enough to compress intracranial contents
Can have compression of oculomotor nerve (III) - fixed and dilated pupil
What layers do subdural haemorrhage occur between?
Dura mater and arachnoid mater
How do subdural haemorrhage occur on CT?
Crescent shape
Cross sutures
Bright compared to brain tissue
What are typical patients for subdural haemorrhage? Why?
elderly
alcoholic patients
they have more atrophy in their brains so vessels are more prone to rupture
What is an intracerebral haemorrhage?
Bleeding into the brain tissue
What are causes of intracerebral haemorrhage?
Spontaneous
Ischaemic stroke
Tumours
Aneurysm rupture
What layers does a subarachnoid haemorrhage occur between?
Pia mater and arachnid membrane
How. can smaller bleeds be managed?
Conservatively with close monitoring and repeat imaging
What are surgical options for extradural or subdural haematomas?
Craniotomy
Burr holes
How do chronic subdural haematomas present?
Several weeks to months progressive history of confusion, reduced consciousness or neurological deficit
