Intracranial Haemorrhage Flashcards

1
Q

name the 3 types of spontaneous intracranial haemorrhage

A

subarachnoid
intracerebral
intraventricular

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2
Q

what bifurcation sites are a common formation point for berry aneurysms?

A
bifurcation of:
basilar
middle cerebral
where ant cerebral meets ant communicating
post comm arising from internal carotid
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3
Q

the headache persists in SAH T or F

A

T

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4
Q

why do you get neck pain, photophobia and nausea in SAH?

A

blood in the spinal SA space irritates the meninges

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5
Q

how is SAH different in presentation from meningitis?

A

SAH is SUDDEN

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6
Q

if a headache takes more than _ mins to peak, its probably benign

A

5

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7
Q

sudden onset headache DDx

A

SAH
migraine
benign coital cephalgia

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8
Q

define benign coital cephalgia; when does the headache start?

A

extreme onset headache during sex, usually just before orgasm

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9
Q

what could present on fundoscopy in a patient with SAH?

A

retinal or vitreous haemorrhage

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10
Q

why is blood dense on CT

A

full of electrons so stops the CT going through it

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11
Q

when should you do LP in a suspected SAH patient?

A

alert patient with:
no focal neuro deficit
no papilloedema
normal CT scan

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12
Q

what is xanthochromic CSF?

A

CSF that has turned yellow from blood breakdown products

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13
Q

how could you differentiate a traumatic tap (touching a vein accidentally) from true bloodstained CSF?

A

take 3 samples and label 1, 2 and 3

if the last bottle has less blood than the first its a traumatic tap

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14
Q

gold standard test for berry aneurysm?

A

cerebral angiography

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15
Q

how is contrast given for CT angiography

A

IV

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16
Q

main electrolyte disturbance in SAH

A

hyponatraemia

17
Q

how are aneurysms treated

A
  1. endovascular treatment

surgical clipping

18
Q

how many days after a bleed does delayed ischaemia present?

A

day 3-12

19
Q

presentation of delayed ischaemia?

A

altered conscious level

focal neuro deficit

20
Q

how is delayed ischaemia prevented?

A

hydrate patient

Ca channel blocker to prevent vasospasm

21
Q

how is hydrocephalus treated in an emergency?

A

LP to drain CSF

22
Q

why should you NOT fluid restrict in hyponatraemia from SAH? what should be done instead?

A

puts the patient at risk of ischaemia

give sodium - fludrocortisone

23
Q

what should be done while you’re waiting on the diagnosis in SAH?

A

bedrest
analgesia
anti-emetic
IV fluids

24
Q

charcot-bouchard microaneurysms cause what type of haemorrhage?

A

hypertensive intracerebral haemorrhage

25
Q

presentation of ICH

A

headache
focal neuro deficit
decreased conscious level

26
Q

non-surgical management of ICH is ideal T or F

A

T

27
Q

Ix of ICH

A

CT

angiography if you’re thinking of a vascular anomaly

28
Q

cause of intraventricular haemorrhage?

A

rupture of a subarachnoid or intracerebral bleed into a ventricle

29
Q

presentation of AVMs

A

seizures
haemorrhage
headache
progressive ischaemia