[SAH] Flashcards
rupture of saccular (aka berry) aneurysm
hereditary weakness in blood vessels (esp. circle of willis)
ant. comm. / ant. cerebral
Post. comm. / internal carotid
AV malformations
3
Aneurysm due to bacterial infection of the vessel wall.
Polycystic kidney
Coarctation of aorta
Ehlers-Danlos (collagen, hypermobile)
Within seconds
worst ever headache
occipital typically
Seizures/collapse
coma (can last days/drowsiness for days)
vomiting
Neck stiffness
Hip and knee flexed 90
extension in the knee is painful (resistance)
SAH
Meningitis
AV malformations
Aneurysm due to bacterial infection of the vessel wall.
worst ever headache
days
SAH
Meningitis
occipital
seconds
Seizure –> coma
Polycystic kidney
Coarctation of aorta
Ehlers-Danlos (collagen, hypermobile)
Neck stiffness
after
vitreous/retinal bleeds - sign of SAH
Prior warning headache (rare)(small leak)
CT
within 48hrs!
LP
> 12hrs
xanthochromia (yellow - bilirubin)
only red in the acute early phase OR a bloody tap
immediately
> 160mmHg
maintain cerebral perfusion
Nimodipine (60mg/4hrs
Ca2+ antagonist - reduced vasospasm
Endovascular coiling
catheter/CT angiography
to identify single or multiple aneurysms
rebleeding
Cerebral ischaemia causing permanent CNS deficits
Cerebral ischaemia causing permanent CNS deficits
rebleeding
cerebral ischaemia
Neck stiffness
cerebral ischaemia
Yes
Yes
blockage of arachnoid granulations
ventricular/lumbar drain