Intracranial Hemorrhage Flashcards
1
Q
Post a SAH, how common is a rebleed?
A
- 50% risk in 1st 6 MONTHS
- 20% risk in 1st 14 DAYS
2
Q
How to manage rebleeds?
A
- with surgical clipping
- endovascular tech.
3
Q
Complications of SAH?
A
Re-bleeding Delayed ischaemic neurological deficit Hydrocephalus Hyponatraemia Seizures
4
Q
When does DIND set in and why?
A
- in days 3-12 post SAH
- d.t large vessel vasospasm
5
Q
How to manage DIND?
A
- –serial neurological examination post-SAH; checking for deterioration of neurological symptoms
- NIMODIPINE
- high fluid intake (Triple H therapy)
6
Q
How does hydrocephalus present as?
A
- 6% is symptomatic
- incr. headache/ altered conscious
- transient
7
Q
How to manage Hydrocephalus?
A
- CSF drainage
- LP
- EVD shunt (ventriculostomy)
8
Q
How does hyponatremia occur post-SAH?
A
- d.t SIADH
- Cerebral salt wasting
- acute cortisol insufficiency
- excessive IV fluid therapy
- diuretic therapy
9
Q
How to manage hyponatremia post-SAH?
A
- do not fluid restrict
- supplement sodium intake
- fludrocortisone
10
Q
How freq. are seizures post-SAH?
A
- 10% risk in 5years
- – 3% ACUTE risk
- —-rx: anti-convulsant prophylaxis
11
Q
How to manage SAH?
A
- bed rest
- Nimodipine (to prevent vasospasm> DIND)
- anti-emetics
- IV fluids
- Analgesia
12
Q
What % of SAH pts die in the first month?
A
50% !
13
Q
Are SAH survivors left with disability?
A
YES
- 50% of them
14
Q
50% of intracerebral hemmorhage is d.t _____
A
-hypertension
15
Q
30% of intracerebral hemorrhage is d.t ________
A
AVMs or Aneurysm
