Intracranial Hemorrhage + Brain Bleeds Flashcards
Epidural hematoma ?
MM
- Rupture=Middle meningeal artery=External carotid artery branch
- Head trauma to the temple
- 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.
Which artery rupture in Epidural hematoma ?
Middle meningeal artery
Epidural hematoma Bleed appear ?
Bleed appears as lens (biconvex) shape; fast accumulating.
Management of Epidural hematoma ?
If low GCS, do “intubation + hyperventilation,” then do craniotomy. If normal GCS, just do
craniotomy.
Subdural hematoma ?
- Superior cerebral vein rupture
- No lucid interval
- patient did not lose consciousness
- Bleed=Crescent shape
- 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)
Tx of subdural hematoma ?
If the patient has decreased Glasgow score, do “intubation + hyperventilation” as answer
before craniotomy
Difference between Epidural and Subdural hematoma ?
Sudural=NO Lucid Interval
Epidural = L I
Subarachnoid hemorrhage ?
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
Stiff neck + HTN
Subarachnoid hemorrhage
Which artery rupture in subarachnoid hemorrhage ?
Rupture of anterior communicating artery (AcoM) or posterior communicating artery
(PcoM) saccular/berry aneurysm
Bleed appearance in Sub arachnoid hemorrhage ?
“star fish” or “sand dollar.”
Where is bleed seen in subarachnoid hemorrhage ?
Basal cisterns
non-HTN causes of saccular aneurysms ?
- Ehlers danlos
- Autosomal dominance Polycystic kidney disease
Intracerebral hemorrhage ?
- Rupture of Charcot-Bouchard microaneurysms within the lenticulostriate arteries in patients who have chronic HTN.
- Bleed + Decornticate posturing = Intracerebral H
- High likelihood of causing = Brainstem compression
- Association = Alzheimer ,Brain Cancer
- Alzheimer = Amyloid angiopathy
- Brain cancer = Glioblastoma multiforme
“X person has bleed + decorticate posturing; what’s the diagnosis?”
Intracerebral hemorrhage
intracerebral hemorrhage has high likelihood
of causing what ?
Brainstem compression
Association of intracerebral hemorrhage ?
- Brain cancer
- Alzheimer
Pituitay apoplexy ?
- Bleeding into the pituitary gland
- Cause = Bitemporal hemianopsia
- Can also occure in = PUERPERIUM
- Cause= Pituitary tumor
Pituitary apolplexy places ?
- Pituitary gland
- Puerperium
Epidural hematoma CT shows what ?
FA
- Not crossing suture line
- Hyperdense blood collection
- Biconvex-Lentiform
528
Subdural hematoma CT shows what ?
- Cross suture lines
- Crescent shaped he,orrhage
- Midline shift
- Acute to chronic hemorrhage
- Hypodense in CT
Subarachnoid hemorrhage ?
FA
- Bloody or yellow-Xanthochromic lumber puncture
- Vasospasm
- Vsospasm-Nimodipine
- Hemorrhae = Ischemic infract
528
Intraparenchymal hemorrhage
Intracerebral hemorrhage
- Caused by systemic HTN
- Amyloid angiopathy
- Arteriovenous hemorrhagic stroke
- Vasculitis
- Neoplasm
- Charcot bouchard microaneursym
- Occure in Basal ganglia of - Putamen /Globus pallidus
- Lenticulostraite vessels
528
Saccular aneurysm in which bleeding ?
Subarachnoid hemorrhage
