Intracranial hemorrhage

Question 1

Name the type of intracranial hemorrhage associated with the following features:

Associated with cerebral arteriovenous malformations

Answer 1

Subarachnoid and intraparenchymal hemorrhage

Question 2

Name the type of intracranial hemorrhage associated with the following features:

Commonly presents with headache and lethargy in a patient with focal motor and sensory defects

Answer 2

Intraparenchymal hemorrhage

Question 3

Name the type of intracranial hemorrhage associated with the following features:

Commonly caused by ruptured berry aneurysm; classically presents as “the worst headache or my life”

Answer 3

subarachnoid hemorrahge

Question 4

Name the type of intracranial hemorrhage associated with the following features:

Hematoma following the contour of a cerebral hemisphere on CT; due to laceration of bridging cerebral veins

Answer 4

Subdural hematoma

Question 5

Name the type of intracranial hemorrhage associated with the following features:

Lens-shaped hematoma on CT scan; due to laceration of middle meningeal artery due to fracture of the temporal bone

Answer 5

Epidural hematoma

Question 6

Name the type of intracranial hemorrhage associated with the following features:

Lumbar puncture (LP) must be performed in a patient with suspected intracranial hemorrhage even if CT scan is negative.

Answer 6

Subarachnoid hemorrhage

Question 7

Name the type of intracranial hemorrhage associated with the following features:

Lucid interval followed by rapid decline in mental status

Answer 7

Epidural hematoma

Question 8

Name the type of intracranial hemorrhage associated with the following features:

May present with meningeal signs, CN palsies, seizures, and focal neurologic signs; bloody or xanthochromic CSF on LP

Answer 8

Subarachnoid hemorrhage (secondary to ruptured aneurysm)

Question 9

Name the type of intracranial hemorrhage associated with the following features:

Most common type of intracranial hemorrhage from trauma

Answer 9

Subdural hematoma (commonly seen in alcoholics and the elderly)

Question 10

Name the type of intracranial hemorrhage associated with the following features:

Treated with emergent neurosurgical evacuation

Answer 10

Epidural hematoma (and subdural hematoma >1 cm or with midline shift)

Question 11

Name the type of intracranial hemorrhage associated with the following features:

Type of intracranial hemorrhage seen in patients with long-standing, poorly controlled hypertension

Answer 11

Intraparenchymal hemorrhage

Question 12

What is the most common cause of subarachnoid hemorrhage?

Answer 12

Trauma

Question 13

What is the most common cause of subarachnoid hemorrhage in a patient with a negative cerebral angiogram?

Answer 13

Perimesencephalic hemorrhage (due to rupture of perimesencephalic veins)

Question 14

Name a vascular complication of subarachnoid hemorrhage that may cause cerebral ischemia:

Answer 14

Vasospasm (peak incidence 6-8 days after hemorrhage)

Question 15

Name four connective tissue disorders associated with an increased risk of cerebral aneurysms:

Answer 15

1. Ehlers-Danlos syndrome
2. Polycystic kidney disease
3. Marfan’s syndrome
4. Coarctation of the Aorta

Question 16

Name the most common cause of subarachnoid hemorrhage in IV drug users:

Answer 16

Ruptured mycotic aneurysms (usually in MCA distribution)

Question 17

What are the two classes of treatment for ruptured cerebral aneurysms?

Answer 17

1. Surgical aneursym clipping
2. Endovascular aneurysm embolization

Question 18

Name the disorer characterized by recurrent ishcemic or hemorrahgec strokes due to progresive idiopathic internal carotic artery stenosis

Answer 18

Moyamoya disease

Question 19

What is the characteristic finding of moyamoya disease on cerebral angiogram?

Answer 19

“Puff of smoke”: due to formation of collateral cerebral vessels originating from the lenticulostriate and thalamoperforating arteries