Neurologic System Flashcards

0
Q

Subdural Hematoma

A
  • Blood collection under the dura
  • Etiology: tearing of bridging veins that pass through the space between the cortical surface and the dural venous sinuses or injury to the brain surface with resultant bleeding from cortical vessels
  • Acute: sx in 24hrs
  • Subacute: sx in 3-14 days
  • Chronic: sx after 2 wks
  • Tx: Craniotomy with clot evacuation
  • CT findings: curved crescent shaped hematoma
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1
Q

Subarachnoid Hemorrhage

A
  • Blood below the arachnoid membrane and above the pia
  • Etiology: Trauma is #1 cause, ruptured berry aneurysm(saccular outpouching of vessels in the circle of Willis usually at bifurcation; occurs most often at anterior communicating artery; polycystic kidney disease and connective tissue disorders such as Marfan’s syndrome increase risk of berry aneurysm), arteriovenous malformation(AVM; congenital abnormality of the vasculature with connections b/t arterial and venous circulations without interposed capillary network).
  • Sx: “worst HA of my life”, neck pain, positive Kernig’s and Brudzinski’s signs, LOC, N/V, photophobia
  • Workup: Head CT, LP, arteriogram to look for aneurysms or AVMs
  • Complications: brain edema–> increased ICP, rebleeding, vasospasm
  • Tx vasospasm: Nimodipine
  • Tx aneurysms: surgical: place metal clip on the aneurysm or balloon occlusion or coil embolization.
  • Tx AVMs: surgical, pre-op embolization, if surgically inaccessible radiosurgery.
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2
Q

Epidural Hematoma

A
  • Collection of blood between the skull and dura
  • Etiology: association with skull fx as bone fragments lacerate meningeal arteries
  • Associated with middle meningeal artery
  • Classic hx: LOC followed by lucid interval followed by neurologic deterioration
  • CT findings: lens shaped hematoma
  • Surgery: surgical evacuation. Indicated in any symptomatic pt or any hematoma >1cm.
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