stroke - hemorrhagic syndromes Flashcards
“Brain PAD”
pia
arachnoid
dura
(from inner to outer)
hemorrhagic syndromes
intracerebral hemorrhage
subarachnoid hemorrhage
intracerebral hemorrhage
bleeding from an arterial source into brain parenchyma
more common in men
what is #1 risk of intracerebral hemorrhage
hypertension
polycythemia
what can lead to bleeding intracerebral hemorrhage
thrombocytes and anticoagulant therapy
pathogenesis intracerebral hemorrhage
smooth muscle replaced by collagen
–> accumulation of deposits on the subintimal wall
clinical manifestations intracerebral hemorrhage
gradual neurologic symptoms
severe headache
syndromes intracerebral hemorrhage
putamen
thalamus
cerebellum
pons
caudate
internal capsule
lobar
which syndrome are seizures more common intracerebral hemorrhage
lobar
subarachnoid hemorrhage
blood in the subarachnoid space b/w the arachnoid and pia maters
spontaneous
often seen in normotensive persons
what’re responsible for most SAH
aneurysm and vascular malformations
clinical manifestations subarachnoid hemorrhage
sentinel headache w/ sudden onset of a “thunderclap” w/ searing pain
very sudden, unlike intracerebral
what percentage of individuals are misdiagnosed individually subarachnoid hemorrhage
38%
what’re individuals misdiagnosed with subarachnoid hemorrhage
viral meningitis
migraine
headache of uncertain etiology
types subarachnoid hemorrhage
berry aneurysm
venous malformations
arteriovenous malformations
cavernous malformation
berry aneurysm
congenital abnormal distension of a local vessel that occurs at a bifurcation
medial later of the vessel is weakest –> branching sites on the large arteries of the circle of willis
venous malformations
veins –> usually thickened and hyalinized w/ minimal elastic tissue or smooth muscle
which individual are at risk for great hemorrhage subarachnoid hemorrhage
cerebellar malformation
arteriovenous malformations
direct artery to vein communication w/o an intervening capillary bed
congenital and occur in cerebral hemispheres
what happens w/ arteriovenous malformations
brain tissue becomes nonfunctional
arteriovenous malformations occur
in the 3rd or 4th decade of life
signs that precede a hemorrhage arteriovenous malformation
seizures
headache
audible bruit
progressive focal neurologic deficits
cognitive decline
how is arteriovenous malformation diagnosed
angiography
cavernous malformation subarachnoid hemorrhage
consists of dilated, endothelium-lined, fibrous channels
autosomal dominance
women more susceptible to hemorrhage
