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Neurology-USMLE > Intracranial Hemorrhage + Brain Bleeds > Flashcards

Intracranial Hemorrhage + Brain Bleeds Flashcards

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USMLE® Step 1 flashcards
1
Q

Epidural hematoma ?

MM

A
  1. Rupture=Middle meningeal artery=External carotid artery branch
  2. Head trauma to the temple
  3. Lucid i interval
    Patients loss consciouness = Arous & Return = Goes back home thinking he is OK = Sleep = Die
    4.Bleed appears as= Lens =Biconvex
    5.GCS(low) = Intubation + Hyperventilation
    6.Then do CRANIOTOMY
    7.Hyperventilation mechanism: decreased CO2= decreased cerebral perfusion = reduces
    intracranial pressure.
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2
Q

Which artery rupture in Epidural hematoma ?

A

Middle meningeal artery

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3
Q

Epidural hematoma Bleed appear ?

A

Bleed appears as lens (biconvex) shape; fast accumulating.

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4
Q

Management of Epidural hematoma ?

A

If low GCS, do “intubation + hyperventilation,” then do craniotomy. If normal GCS, just do
craniotomy.

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5
Q

Subdural hematoma ?

A
  1. Superior cerebral vein rupture
  2. No lucid interval
  3. patient did not lose consciousness
  4. Bleed=Crescent shape
  5. Tx=- If the patient has decreased Glasgow score, do “intubation + hyperventilation” as answer
    before craniotomy.
    6.- Increased risk in elderly/dementia and alcoholics; answer in acceleration-deceleration
    injuries (shaken baby syndrome; motor vehicle accidents)
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6
Q

Tx of subdural hematoma ?

A

If the patient has decreased Glasgow score, do “intubation + hyperventilation” as answer
before craniotomy

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7
Q

Difference between Epidural and Subdural hematoma ?

A

Sudural=NO Lucid Interval
Epidural = L I

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8
Q

Subarachnoid hemorrhage ?

A

1.Rupture of anterior communicating artery (AcoM) or posterior communicating artery (PcoM)
2.AcoM > PcoM in terms of location.
3.Worst ehadache in life
4.Present with STIFF NECK ( Meningism )
5.HTN common
6.PcoM-Ipsilateral blown pupil
7.Ehlers-Danlos and autosomal dominant polycystic kidney disease (ADPKD) are HY non HTN-associated specific causes of saccular aneurysms.
8.Bleed= Star fish /Sand dollar
9.Blood visualize in the = Basal cisterns
10.Tretment =HTN must be controlled + Nimodipine + Warfarin + Anticoagulants

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9
Q

Stiff neck + HTN

A

Subarachnoid hemorrhage

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10
Q

Which artery rupture in subarachnoid hemorrhage ?

A

Rupture of anterior communicating artery (AcoM) or posterior communicating artery
(PcoM) saccular/berry aneurysm

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11
Q

Bleed appearance in Sub arachnoid hemorrhage ?

A

“star fish” or “sand dollar.”

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12
Q

Where is bleed seen in subarachnoid hemorrhage ?

A

Basal cisterns

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13
Q

non-HTN causes of saccular aneurysms ?

A
  1. Ehlers danlos
  2. Autosomal dominance Polycystic kidney disease
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14
Q

Intracerebral hemorrhage ?

A
  1. Rupture of Charcot-Bouchard microaneurysms within the lenticulostriate arteries in patients who have chronic HTN.
  2. Bleed + Decornticate posturing = Intracerebral H
  3. High likelihood of causing = Brainstem compression
  4. Association = Alzheimer ,Brain Cancer
  5. Alzheimer = Amyloid angiopathy
  6. Brain cancer = Glioblastoma multiforme
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15
Q

“X person has bleed + decorticate posturing; what’s the diagnosis?”

A

Intracerebral hemorrhage

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16
Q

intracerebral hemorrhage has high likelihood
of causing what ?

A

Brainstem compression

17
Q

Association of intracerebral hemorrhage ?

A
  1. Brain cancer
  2. Alzheimer
18
Q

Pituitay apoplexy ?

A
  1. Bleeding into the pituitary gland
  2. Cause = Bitemporal hemianopsia
  3. Can also occure in = PUERPERIUM
  4. Cause= Pituitary tumor
19
Q

Pituitary apolplexy places ?

A
  1. Pituitary gland
  2. Puerperium
20
Q

Epidural hematoma CT shows what ?

FA

A
  1. Not crossing suture line
  2. Hyperdense blood collection
  3. Biconvex-Lentiform

528

21
Q

Subdural hematoma CT shows what ?

A
  1. Cross suture lines
  2. Crescent shaped he,orrhage
  3. Midline shift
  4. Acute to chronic hemorrhage
  5. Hypodense in CT
22
Q

Subarachnoid hemorrhage ?

FA

A
  1. Bloody or yellow-Xanthochromic lumber puncture
  2. Vasospasm
  3. Vsospasm-Nimodipine
  4. Hemorrhae = Ischemic infract

528

23
Q

Intraparenchymal hemorrhage

Intracerebral hemorrhage

A
  1. Caused by systemic HTN
  2. Amyloid angiopathy
  3. Arteriovenous hemorrhagic stroke
  4. Vasculitis
  5. Neoplasm
  6. Charcot bouchard microaneursym
  7. Occure in Basal ganglia of - Putamen /Globus pallidus
  8. Lenticulostraite vessels

528

24
Q

Saccular aneurysm in which bleeding ?

A

Subarachnoid hemorrhage

25
Q

Vasospasm can be prevent by which drug in sub arachnoid hemorrhage ??

A

Nimodipine

26
Q

Charcot bouchard microaneurysm in which bleeding ?

A

Intraparenchymal /INtracerebral hemoorhage

528

27
Q

Chronic alcohol over use + Shaken babies which hemorrhage?

A

Subdural hemorrhage

28
Q

Risk of communicating or obstructive HYDROCEPHALUS ??

A

Subarachnoid hemorrhage

29
Q

Pterion associated in which hemorrhage ?

A

Epidural hemorrhage

30
Q

Women Give birth + Bitemporal hemianopsia =

Visual [pattern ]

A

Pituitary apoplexy

Neurology-USMLE (6 decks)

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