Neurology 2 - Intracranial Bleeds Flashcards
proportion of strokes caused by intracranial bleeds
10-20%
risk factors intracranial bleed
head injury high BP aneurysms isch stroke brain tumours anticoag
presenting features of intracranial bleed
sudden onset headache
seizures weakness vomiting low GCS sudden onset neuro
GCS score for considering securing airway
8 or below / 15
eyes section of GCS
4 spontaneous
3 open to speech
2 open to pain
1 none
speak section of GCS
5 orientated 4 confused conversation 3 inappropriate use of words 2 incomprehensible mumbling 1 none
moving section of GCS
6 moves on command 5 moves to localise pain 4 normal flexion seen 3 abnormal flexion seen 2 extension 1 none
subdural haemorrhage key info
vessels, where, CT, who
rupture of bridging veins in outermost meningeal layer
(i.e. between dura mater and arachnoid mater)
CT scan - crescent shape not limited by cranial sutures
elderly / alcoholic more likely as atrophic
extradural haemorrhage key info
rupture of middle meningeal artery in temporoparietal region
between skull and dura mater
CT biconvex shape + limited by cranial sutures
young with head trauma, brief improv, then crash
subarachnoid haemorrhage key info
bleeding between pia mater and arachnoid membrane
ruptured aneurysm often
sudden occipital thunderclap headache
assoc cocaine + sickle cell
management of intracranial bleeding
immediate CT head + Dx check FBC + clotting admit to stroke unit discuss surgical input consider ITU if low GCS correct clotting correct sever HTN (but do not overcorrect)
