Hemorhagicc stroke

Question 1

What are the risk factors for Intraparenchymal hemorrhage?

Answer 1

Hypertension Coagulopathy Vascular malformation (Aneurysm, AVM) Tumor (EG. Melanoma, Cerebral amyloid angiopathy)

Question 2

Where is the usual locations of a hypertensive hemorrhage?

Answer 2

• Deep Gray Nuclei (Basal Ganglia, Thalamus)
• Pons
• Cerebellum

Pic: example of basal ganglia and talmus hemorhage

Question 3

Example of pons and cerebellum image

Answer 3

Question 4

What is a hemorhage at the grey white junction of the cerebrum suggestive of?

Answer 4

a underlying metastatic lesion

Question 5

Cerebral amyloid angiopathy

Answer 5

ussually found in older patients

Question 6

How do you manage a intraparachymal hemorhage?

Answer 6

• Blood pressure control
• Address coagulopathy
• Identify/address underlying structural abnormality
• Consider Neurosurgical decompression

Question 7

Interventricular hemorhage

Answer 7

hydrocephaly could be a problem

Question 8

Subdural hematomal

Answer 8

low pressure-venous blood

blood is irritating to the brain

old people are ussally the problem because thier brain shrinks, recurents can happen

Question 9

What is diagnostic of Epidural Hematoma?

Answer 9

• High pressure arterial bloodflow
• Middle Meningeal Artery
• Lucid Interval

lens shaped

Question 10

What are risk factors of venous sinuses thrombosis?

Answer 10

Hypercoagulable

• Genetic
• Pregnancy
• Malignancy
• Inflammatory disease
• Infection

Pic: left side is venous rupture. bloody because blood cant leav via veins

Right: pale with cherry macula

Question 11

What is a thunderlap headche?

Answer 11

aneurysmal subarachnoid

Traumatic sub rachnoid

Question 12

Aneurysmal subarachnoid hemorhage?

Answer 12

Question 13

Traumatic subarachnoid hemorhage

Answer 13

Question 14

How are subarachnoid hemorhage diagnosed?

Answer 14

• Noncontrast CT
• If CT nondiagnostic–Lumbar puncture (Elevated RBCs in CSF, Elevated RBCs in tubes 1-4-if blood is in all tubes, Xanthochromia-pigment released from RBCs in the CSF, Consider repeating 6 hours after onset of symptoms)
• Angiography

Question 15

What are complications of Subarachnoid hemorhage?

Answer 15

• Death- a lot die)
• Re-bleed (Early clip or coil)
• Seizure
• Hydrocephalus
• Vasospasm(Peak day 8)- irritation by blood, can have ishema stroke
• Nimodipine
• Pulmonary edema
• Cardiac arrhythmia
• Hyponatremia