Neuro - head presentations Flashcards
INTRACRANIAL BLEEDS
i) name four RF? what is a key px feature?
ii) what three things is GCS based on? a score below what needs securing of airway?
iii) which type of haemm is caused by rupture of bridging veins? where are they found? what shape will be seen on CT? which two patients are most at risk of this
iv) what causes an extra dural? what shape is seen on CT? does it cross the sutures?
v) what is the usual cause of SAH? wht is the typical history? name two other things it can be associated with?
i) RF - head injury, high BP, aneurysm, isch stroke can progress, brain tumour, anticoag
key px feature is sudden onset headache
can also px with seizure, weak, vomit, reduced conc
ii) GCS = eyes, verbal, motor response
<8 - coma and secure airway
iii) subdural - rupture of bridging veins found between dura and arach
crescent shape on CT - elderly and alcoholics
iv) extra dural = lens shaped - rupture of middle meningeal artery and occ between skill and dura and are limited by cranial sutures
v) SAH - ruptured ceb aneurysm
sudden onset occipital heaadache occ during strenous activity - thunderclap headache
can also be assoc with cocaine and SCA
INTRACRANIAL BLEEDS
what are the 7 principles of mx
1) immediate head CT to establish dx
2) check FBC and clotting
3) admit to spec stroke unit
4) discuss with neurosurgery
5) consider intubation and ventilation if reduced conc
6) correct any clotting abnorms
7) correct severe hypertension but avoid hypotension
