Neuro9 Flashcards
Intracranial Hemorrhage
Epidural hematoma results from a rupture of what?
Middle Meningeal Artery
*often 2˚ to fracture of Temporal bone
Subdural hematoma results from a rupture of what?
Bridging veins
Epidural or Subdural:
-Lucid Interval
Epidural
“talk and die” phenomena
*patient recovers after trauma, seems fine death quickly follows
Epidural or Subdural:
- Crescent-shaped lesion on CT
- Biconcave (lentiform) lesion on CT
Subdural = Crescent
Epidural = Lentiform (biconcave)
Epidural or Subdural:
- High Pressure
- Low Pressure
Epidural = High
Subdural = Low
Epidural or Subdural:
-Common in elderly
Subdural
Epidural or Subdural:
-Alcoholics
Subdural
Epidural or Subdural:
-Blunt trauma
Subdural
Epidural or Subdural:
-Crosses suture lines
Subdural
epidural = does NOT cross suture lines
Epidural or Subdural:
Can cross falx, tentorium
Epidural
subdural = does NOT cross falx, tentorium
Epidural or Subdural:
-Progressive neurological signs
Subdural
Epidural or Subdural:
-Transtentorial herniation
Epidural
Epidural or Subdural:
-CNIII palsy
Epidural
Epidural or Subdural:
-Hyperdense blood collection
Epidural
Epidural or Subdural:
-Midline shift
Subdural
Where is the blood in an Epidural hematoma?
Between Skull and Dura mater
Where is the blood in a Subdural hematoma?
Between Dura & Arachnoid
Epidural or Subdural:
-More common
Subdural
What is the most common cause of a Subarachnoid hemorrhage?
Rupture of a berry aneurysm
- Anterior circle of Willis @ branch points of Anterior Communicating Artery
*also ArterioVenous Malformation (AVM)
What are the symptoms of a Subarachnoid hemorrhage?
“Worst Headache of my Life” (WHOML)
Nuchal Rigidity
What makes Berry Aneurysms more likely in some congenital syndromes?
Lack tunica Media & Elastic lamina (congenital)
*Marfan’s, Ehlers-Danlos, ADPKD
Where is the blood in a subarachnoid hemorrhage?
Area between the arachnoid membrane and the pia mater surrounding the brain.
What is the diagnostic technique of choice for a subarachnoid hemorrhage?
CT w/o Contrast
What should you do if CT comes back negative but you still suspect a subarachnoid hemorrhage?
Lumbar puncture
- Bloody or Yellow (Xanthochromic) CSF
What is the most common cause of an Intraparenchymal hemorrhage?
Systemic HYPERtension
Where does an intraparanchymal hemorrhage typically occur?
Basal Ganglia & Internal Capsule
- Charcot-Bouchard aneurysms of Lenticulostriate vessels
*can also be lobar
