S4 L2 Integrated cases

Question 1

Not much new material - but see PP seperate if want more details…

• When thinking about differentials, think about all body systems (not just the system the question is on!)

Question 2

Symptoms of:

• Extradural haemorrhage
• Subdural haemorrhage
• Subarachnoid haemorrhage
• Subaponeurotic haemorrhage
• What colour is blood on CT and x-ray?

Answer 2

• Extradural haemorrhage: e.g. MMA, lentiform shape haemorrage (biconvex)
  Unconscious, then regains consciousness and enters lucid interval, then later deteriorates neurologically (e.g. confused, drowsy…)
• Subdural haemorrhage: banana shape haemorrhage
  gradual deterioration, common in elderly
• Subarachnoid haemorrhage
  sudden headache, ‘hit on back of the head’, meningism - photophobia, neck stiffness
• Subaponeurotic haemorrhage:
  not an intracranial haemorrhage, bleeding within scalp layers

Blood is white

Question 3

Rik of a TIA?

Amaurosis Fugax:

• What is this?
• Potential causes
• How to identify internal carotid artery on arteriogram?

Answer 3

TIA - transient ischaemic attack

Risk of progression to full stroke

Amaurosis Fugax:
​- What is this? Type of TIA
- Potential causes: A.fib, forming a thrombus…
Turbulent flow at the common carotid bifurcation…

Arteriogram:
Internal carotid artery (no branches)