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Neurology > Subarachnoid Haemorrhage > Flashcards

Subarachnoid Haemorrhage Flashcards

1
Q

What is a subarachnoid haemorrhage?

A

Presence of blood within the subarachnoid space

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2
Q

What is the subarachnoid space?

A

Between the pia and arachnoid layer of the meninges.

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3
Q

What are the 2 classifications of causes of subarachnoid haemorrhage?

A

Spontaneous
Trauma

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4
Q

What are spontaneous causes of a subarachnoid haemorrhage?

A

Rupture of a berry aneurysm
Arteriovenous malformation

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5
Q

How does a subarachnoid haemorrhage present?

A

• Sudden severe onset occipital headache
• Nausea and vomiting
• Meningism- photophobia, neck stiffness
• Coma, seizure and collapse

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6
Q

Where would you feel a headache with a subarachnoid haemorrhage?

A

Occipital region

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7
Q

How would you diagnose a subarachnoid haemorrhage?

A

Non-contrast CT of head

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8
Q

What are the other possible ways to diagnose a subarachnoid haemorrhage?

A

Lumbar puncture

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9
Q

What would you find with a lumbar puncture of someone with a subarachnoid haemorrhage?

A

Xanthochromia
(yellow CSF)

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10
Q

When is a lumbar puncture done on someone with a SAH?

A

12 hours after
To allow the blood to break down

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11
Q

What would you use to confirm the cause/location of a SAH?

A

CT intracranial angiogram

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12
Q

What would you find on an ECG if someone has had a SAH?

A

ST elevation
Inverted T wave

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13
Q

What is the management of a SAH?

A

• Endovascular coiling
• Nimodipine

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14
Q

What is the function of Nimodipine?

A

Prevents vasospasm

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15
Q

What are possible complications of a SAH?

A

• Rebleeding
• Vasospasm
• Hyponatraemia

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16
Q

What would you do if you suspected re-bleeding?

A

CT of head

17
Q

What can cause the pain to become worse in someone presenting with a subarachnoid haemorrhage?

A

Bending neck

18
Q

What are two rarer causes of a SAH?

A

pituitary apoplexy
mycotic (infective) aneurysms

19
Q

What might you see on examination with an opthalmoscope?

A

Retinal haemorrhages

20
Q

What is a common consequence of SAH?

A

SIADH

21
Q

How can SIADH present?

A

SIADH leads to hyponatremia and therefore symptoms of low sodium including nausea, vomiting, headaches, muscle cramps, and reduced consciousness.

Neurology (63 decks)

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