Flashcards in Intracerebral Hemorrhage Deck (22)
When do intracerebral hemorrhages tend to occur?
suddenly, without warning, during activity
What are intracerebral hemorrhages associated with?
advanced age and male sex
What are spontaneous, nontraumatic, intracerebral hemorrhage in patients with no angiographic evidence of an associated vascular anomaly due to?
What is the pathologic basis for hemorrhage?
the presence of microaneurysms that develop on perforating vessels in hypertensive patients
Where do hypertensive intracerebral hemorrhages typically occur?
in the basal ganglia
What results when the hemorrhage extends into the subarachnoid space?
signs of meningeal irritation emerge
What s a frequent cause of hemorrhage in the elderly?
Cerebral amyloid angiopathy
Hemorrhage caused by cerebral amyloid angiopathy has a _____ prognosis than hypertensive hemorrhage
List 5 other causes of nontraumatic intracerebral hemorrhage
- hematologic and bleeding disorders (leukemia, thrombocytopenia, hemophilia, or disseminated intravascular coagulation)
- anticoagulant therapy
- liver disease
- high alcohol intake
- primary or secondary brain tumors
Are women or men more prone to intracerebral hemorrhages
Where does bleeding occur primarily?
in the subarachnoid space when it occurs in from an intracranial aneurysm or arteriovenous malformation
What are the 3 general signs and symptoms of intracerebral hemorrhages?
- Lost or impaired consciousness
What typically occurs with hypertensive hemorrhage?
a rapidly evolving neurologic deficit with hemiplegia or hemiparesis
What do cerebellar hemorrhages present as?
- sudden onset of nausea and vomiting
- loss of consciousness that may terminate fatally within 48 hours
What imaging modality is the best at detecting intracranial hemorrhage less than 48 hours old?
CT without contrast
What image finding is a predictor of poor outcome?
What lab values may reveal a predisposing cause for hemorrhage?
- complete blood count
- platelet count
- bleeding time
- prothrombin and partial thromboplastin times
- liver and kidney function tests
What special test is contraindicated and why?
Lumbar puncture because it may precipitate a herniation syndrome in patients with a large hematoma
Treatment for intracranial hemorrhage is typically _____ and ______.
conservative and supportive
Describe treatment options
- ventilatory support
- blood pressure regulation
- seizure prophylaxis
- control of fever
- nutritional supplementation
What may be required in patients with intraventricular hemorrhage and acute hydrocephalus?