(27B) Hemorrhagic Stroke Flashcards Preview

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Flashcards in (27B) Hemorrhagic Stroke Deck (17):
1

most common cause of a SAH

rupture of berry or saccular aneurysm

2

what size berry aneurysm is likely to bleed

50% that are 2-5 mm will and many > 5mm

3

what is the etiology of berry aneurysms?

developmental defect in blood vessel wall

4

are berry aneurysms more like like in anterior or posterior circulation?

anterior (85%) > posterior (15%)

5

what genetic diseases predispose someone to SAH

marfans and polycystic kidney disease

6

risk factors for SAH

stimulant drugs (cocaine)
OCPs
tobacco and ETOH
HTN
LOW cholesterol

7

Signs and symptoms of SAH

SYMPTOMS:
headache ("worst of life")
neck stiffness/pain
photo or phonophobia
N/V
**Focal neuro signs may be ABSENT**

SIGNS:
elevated BO it arrhythmias
retinal hemorrhages

8

what causes the pain, photo or phonophobia in an SAH

RBCs lyse and breakdown products irritate the meninges

9

what causes the elevated BP and arrhythmias in SAH

RBC lyse and products irritate the brainste, center that regulates HR

10

most imp test to reveal SAH or bleeding in brain

CT

*gold std = 4-vessel digital subtraction arterography

11

When do you get an LP when you suspect SAH? Why?

3-4 hrs after onset of headache--bc you want to allow enough time for the RBCs to lyse and have time for our tests to detect the Hgb

12

with a LP, how can your differentiate a SAH from just nicking a vein?

IMMEDIATELY spin down--RBC breakdown products vs actual RBCs

13

treatment for SAH

interventional radiology to coil or clip aneurism

14

3 most common causes for parenchymal hemorrhages from most to least common

trauma > HTN > AVM

15

What are Charcot Bouchard aneurysms? What causes them?

micro aneurysms caused by HTN

16

5 most common areas of bleeding caused by HTN (from most to least common)

basal ganglia > thalamus > cerebellum > pons
*see Charot Bouchard aneurysms in these locations

17

treatment for AVM

fix AVM with coils or remove AVM