Haemorrhage

Question 1

What are three examples of vascular pathology that are often associated with haemorrhage?

Answer 1

Aneurysm, AVM, Hypertension

Question 2

Where does brain haemorrhage most commonly occur?

Answer 2

Basal ganglia, thalamus, cerebral white matter and cerebellum

Question 3

what are the 3 types of spontaneous haemorrhage?

Answer 3

Intracerebral haemorrhage
Sub-arachnoid haemorrhage
Haemorrhagic infarct

Question 4

What are the 5 types of traumatic haemorrhage?

Answer 4

Extra-dural
Sub-dural
Contusion
Intracerebral
Sub-arachnoid

Question 5

On morphology of cut surface of a haemorrhage there will be well-demarcated intra-parenchymal haemoatomas and oedema but no necrosis TRUE/FALSE

Answer 5

TRUE

Question 6

Which two groups of people are falls most common in?

Answer 6

Those with drinking problems

The elderly

Question 7

What is the mortality associated with an acute subdural haemorrhage?

Answer 7

> 60% mortality

Question 8

Which type of haemorrhage is associated with disruption of the bridging veins?

Answer 8

Subdural haemorrhage

Question 9

Berry aneurysm is associated with what condition?

Answer 9

PKD

Question 10

3 causes of subarachnoid haemorrhage?

Answer 10

1- Circle of Willis aneurysm
2-AVM
3-No underlying cause

Question 11

Which type of haemorrhage does this describe?

Answer 11

Sudden onset severe headache, less than 5m to peak

Question 12

What are the two differential diagnosis of subarachnoid haemorrhage?

Answer 12

Migraine

Benign coital cephalgia

Question 13

If the CT scan is negative then what is the gold standard to find if the patient has a bleed?

Answer 13

Lumbar puncture

Question 14

What technique is used to find where the bleed is?

Answer 14

Cerebral angiography

Question 15

In a young person you often don’t see the temporal horns of lateral ventricles. If you do then the YP has …

Answer 15

Raised CSF

Question 16

What does delayed ischaemia neurological deficit (DIND) look like?

Answer 16

3-12 days after
Altered consciousnes level or focal deficit
Vasospam is the underlying problem

Question 17

What is the treatment for delayed ischemia neurological deficit?

Answer 17

Triple H therapy- induced...
-Hypertension
-Hypervolaemia
-Hemodilution
NIMODIPINE AND HIGH FLUID INTAKE

Question 18

AVM are a risk to bleeding but also….

Answer 18

Can act as SOLs which can grow and lead to focal neurological deficits

Question 19

There is secondary meningitis with intracerebral haemorrhage TRUE/FASLE

Answer 19

FALSE

The bleed is contained therefore don’t get secondary meningitis

Question 20

What are the two investigations that would be done in intracerebral haemorrhage?

Answer 20

CT Scan

Angiography