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Y3 Neurology > Cerebral Haemorrhage > Flashcards

Cerebral Haemorrhage Flashcards

1
Q

what conditions are linked to cerebral aneurysms

A

PKD, fibromuscular dysplasia, EDS

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2
Q

90% of cerebral aneurysms are in the posterior circulation. T or F

A

F, 90% in anterior circulation

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3
Q

what is the commonest type of cerebral aneurysm

A

saccular Berry aneurysm

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4
Q

how do saccular Berry aneurysms present

A 
SAH
CN palsy (unruptured)
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5
Q

an aneurysm of what intracerebral artery often presents with a dilated unresponsive pupil due to a CN III palsy

A

posterior communicating artery

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6
Q

management of cerebral aneurysms

A

endovascular coil or clipping

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7
Q

aneurysms often arise at arterial bifurcations, T or F

A

T

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8
Q

AV malformations can cause steal syndrome, what is the pathology of this

A

‘steal’ blood causing local ischaemia

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9
Q

presentation of a AV malformation

A

bleed
seizure
HA
neuro deficit

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10
Q

diagnostic test for AVMs

A

catheter angiogram

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11
Q

management of AVMs

A

some kind of surgery

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12
Q

gold standard test for cavernous malformations

A

MRI (not seen on angiogram)

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13
Q

a congenital Berry aneurysm bursting causes what type of cerebral haemorrhage

A

SAH

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14
Q

as well as those with Berry aneurysms, what is another risk factor for subarachnoid haemorrhage

A

alcoholism

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15
Q

do subarachnoid haemorrhages always have a precipitant eg. a fall

A

no

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16
Q

in subarachnoid what pathological process occurs secondary to bleeding

A

chemical meningitis

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17
Q

subarachnoid haemorrhage causes a chemical meningitis. how does chemical meningitis present

A

headache, neck stiffness, photophobia

collectively meningism

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18
Q

what is the presentation of subarachnoid haemorrhage due to a berry aneurysm rupture

A

acute severe thunderclap HA
meningism
N&V
focal signs

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19
Q

in SAH, where does the headache typically begin

A

occiput

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20
Q

how does the presentation of a subarachnoid haemorrhage due to berry aneurysm rupture and secondary to trauma differ?

A

after head trauma can take weeks to develop

aneurysm rupture always acute

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21
Q

what is the 1st investigation for subarachnoid haemorrhage

A

CT brain

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22
Q

what is seen on CT in SAH

A

hyperdense lesion

23
Q

when investigating SAH, if CT is negative or positive, what test should do you next? this is the GOLD STANDARD test for SAH

A

LP

24
Q

when is LP contraindicated in SAH

A

neuro defecit or sign of raised ICP

25
Q

what is seen in CSF LP in SAH

A

blood, xanthochromia

26
Q

what is the definitive Dx of a cerebral aneurysm

A

cerebral angiography

27
Q

what is the treatment of SAH

A

supportive + endovascular surgical clip

28
Q

what is the major complication with morbidity in SAH

A

rebleeding

29
Q

what complication of SAH presents with a worsening headache or decreasing consciousness

A

hydrocephalus (drain at LP or shunt)

30
Q

what complication of SAH presents after 3-12 days with decreasing consciousness or a focal defecit?

A

delayed ischaemia

31
Q

what is the general mechanism of delayed ischaemia following SAH

A

vasospasm

32
Q

what is given as delayed ischaemia prophylaxis following SAH

A

hydration + nimodipine CCB

33
Q

which type of cerebral haemorrhage is linked to Charcot Bouchard microaneurysms

A

intracerebral haemorrhage

34
Q

what structure of the brain is often affected by intracerebral haemorrhages

A

basal ganglia

35
Q

how do intracerebral haemorrhages present

A

HA, focal deficit, decreasing consciousness

36
Q

investigation for intracerebral haemorrhages

A

CT

37
Q

which cerebral haemorrhage is associated with falls in the elderly

A

subdural haemorrhage

38
Q

where is the bleeding in subdural haemorrhage

A

between dura and arachnoid

39
Q

what is the general pathology of subdural haemorrhage

A

bridging vein rupture

40
Q

subdural haemorrhages can present acutely or chronically. what is the general acute presentation?

A

acute loss of consciousness

41
Q

subdural haemorrhages can present acutely or chronically. what is the general chronic presentation?

A

insidious HA, confusion, incontinent, seizure, gait disturbance
over 3-7wk

42
Q

what is seen on CT in acute subdural haemorrhage

A

hyperdense crescent appearance

43
Q

what is seen on CT in chronic subdural haemorrhage

A

hypodense crescent

44
Q

are chronic or acute subdural haemorrhages more easily precipitated by minor trauma?

A

chronic

45
Q

what medication is a risk factor for chronic subdural haemorrhages

A

aspirin

46
Q

is a neomembrane present in chronic or acute subdural haemorrhages?

A

chronic

47
Q

where is the bleeding in extradural haemorrhages?

A

between bone and dura

48
Q

commonest mechanism of extradural haemorrhages?

A

linear pterion fracture; ruptures middle meningeal artery

49
Q

are extradural haemorrhages more common in younger or old PTx

A

younger

50
Q

presentation of extradural haemorrhages

A

head trauma + LOC

lucid interval followed by

51
Q

complication of extradural haemorrhages

A

uncal herniation

52
Q

what is seen on CT in extradural haemorrhage

A

hyperdense biconvex lens appearance (LOOK UP PICTURES OF IT, YOU SHOULD BE ABLE TO IDENTIFY IT)

53
Q

management of extradural haemorrhage

A

sometimes surgery, sometime conservative

Y3 Neurology (23 decks)

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