Q2- Intracranial Vascular Diseases

Question 0

Other examples of Intracranial Vascular Diseases

Answer 0

Cortico-Cavernous Fistula
Ischemic Dses of the Brain
Cranial Decompression 2’ to a malignannt brain edema (MCA infarct)

Question 1

Give most common examples of

INTRACRANIAL VASCULAR DISEASES.

Answer 1

Aneurysm
Arterio-Venous Malformation
Hypertensive Intracerebral / Cerebellar Hemorrhage

Question 2

Most common cause of Subarachnoid Hemorrhage (SAH)?

Answer 2

Trauma

Question 3

Most common cause of spontaneous SAH (no precipitating event)?

Answer 3

Intracranial Aneurysms

75-80%

Question 4

Causes of Spontaneous SAH

Answer 4

Intracranial Aneurysms (75-80%)
ArterioVenous Malformation (4-5%)
Bleeding diathesis
Anticoagulants
Vasculitis
Undefined

Question 6

Clinical Manifestations of SAH

Answer 6

Sudden, severe headache
Loss of consciousness
Seizures
Meningismus
Preretinal hemorrhages

Question 7

Risk factors of SAH

Answer 7

Hypertension
Smoking
Female
Oral contraceptives
Alcohol
Familial hx

Question 8

Major cause of morbidity and mortality of SAH

Answer 8

Rebleeding

Question 9

Vasospasm

Answer 9

1st chance= day 3

Peak= day4-10/11

Question 10

One of the most dreaded complication of aneurysm

Answer 10

Vasospasm

Question 11

How do we know if there is aneurysm if most are Asymptomatic? Only 25-30% are Symptomatic.

Answer 11

Do angiogram to check caliber of bld vessels

Question 12

Cause of aneurysm

Answer 12

Missing intrinsic elastic lamina

Question 13

One of themost common factor of the rupturing of aneurysm

Answer 13

Hypertension!!

Question 14

Procedure done to collect CSF for analysis

Answer 14

Lumpar puncture

Question 15

CSFanalysis:

Fluid clears progressively in successive samples

Answer 15

Traumatic Tap

Question 16

CSFanalysis:
Uniform, bloody, orange color
Does NOT clot

Answer 16

Subarachnoid hemorrhage

Question 17

CSFanalysis:

Xanthrochromic (yellowish)

Answer 17

Ruptured aneurysm
Hgb release or
Bilirubin formation

Question 18

Locations of aneurysm ( at bifurcation)

Answer 18

Most common= anterior circulation 85%

Posterior circulation 15%

Question 19

Giant aneurysm

Answer 19

> /= 2.5cm

Question 20

Plain CTscan: white = ….

Answer 20

White = blood = SAH until proven otherwise

Question 21

Grading scale for Management of patients

Answer 21

Hunt and Hess SAH Grading Scale

Question 22

Hunt and Hess SAH Grading Scale

Grade 1

Answer 22

5% mortality
Asymptomatic
Minimal headache

Question 23

Hunt and Hess SAH Grading Scale

Grade 2

Answer 23

10% mortality
Oculomotor palsy
Normal LOC

Question 24

Hunt and Hess SAH Grading Scale

Grade 3

Answer 24

Change in sensorium

Question 25

Hunt and Hess SAH Grading Scale | Grade 4

Answer 25

60% mortality Stupor hemiparesis

Question 26

Hunt and Hess SAH Grading Scale | Grade 5

Answer 26

Almost 100% mortality Comatose Moribound with decerebrate posturing

Question 27

Hunt and Hess SAH Grading Scale | Grade 0

Answer 27

0-2% mortality Unruptured aneurysm Asymptomatic Incidental finding

Question 28

Grading system for VASOSPASM development

Answer 28

Fisher Grade

Question 29

Fisher Grade 1

Answer 29

No hemorrhage evident

Question 30

Fisher Grade 2

Answer 30

SAH

Question 31

Most aneurysms (>90%) are found..

Answer 31

At the bifurcation