intracranial bleeding

Question 1

what is the main cause of idiopathic intracranial hypertension ?

Answer 1

pseudotumor cerebri

Question 2

what is the cause of headache in increased ICP ?

Answer 2

pain fibers CN 5 in dura

Question 3

what is the description of papilledema ?

Answer 3

blurred edges of the optic disc on fundoscopy

Question 4

what is the cushing triad ?

Answer 4

hypertension
bradycardia
irregular respiration which is the triad associated with high ICP

Question 5

what are the different abnormal motor posturing ?

Answer 5

theres decorticate and decerebrate

Question 6

what are the features of the decorticate posture and where is the site of the lesion ?

Answer 6

site of lesion : above the red nucleus (cerebral cortex)
overactive sites: rubrospinal and vestibulospinal tracts
presentation : upper limb flexion , lower limb extension

Question 7

what are the features of decerebrate posturing ?

Answer 7

site of lesion : between red and vestibular nuclei (brainstem)
overactive tract: vestibulospinal tract
presentation : upper and lower limb extension

Question 8

which of the two abnormal posturing is worse ?

Answer 8

the decerebrate posture

Question 9

what are the common places for herniations of the brain ?

Answer 9

1- cingulate/subfalcine herniation under the falx cerebri
2- central/downwards transtentorial herniation
3- uncal transtentorial herniation
4- cerebellar tonsillar herniation into the foramen magnum

Question 10

what are the consequences of the cingulate/subfalcine herniation ?

Answer 10

compresses the anterior cerebral artery

Question 11

what are the consequences central/downward transtentorial herniation?

Answer 11

caudal displacement of the brainstem , which causes rupture of the paramedian basilar artery branches causing duret hemorrhage

Question 12

what are the consequences of uncal transtentorial herniation ?

Answer 12

uncus=medial temporal lobe
early on : causes ipsilateral blown pupil, contralateral hemiparesis

later on: kernohan phenomenon , which is a false localizing sign , where there is affection on the same side when there is sever herniation

Question 13

what are the consequences of cerebellar tonsillar herniation ?

Answer 13

coma and death due to compression of the brainstem

Question 14

what are the types of intracranial bleeds ?

Answer 14

epidural hematoma
subdural hematoma
subarachnoid hemorrhage
hemorrhagic stroke

Question 15

what is an epidural hematoma a result of ?

Answer 15

rupture of the middle meningeal artery , which is a branch of the maxillary artery usually after fracture of the temporal bone

Question 16

what is seen on imaging of an epidural hematoma ?

Answer 16

convex shape on CT

Question 17

what is the presentation of epidural hematoma ?

Answer 17

knocked out by the concussion
associated with lucid interval

Question 18

what is the usual cause of subdural hematomas ?

Answer 18

usually traumatic
rupture of the bridging veins

Question 19

where is the blood leakage in association with subdural hematomas ?

Answer 19

blood between the dura and the arachnoid space , slow bleeding due to low pressure veins

Question 20

what is seen on imaging of a subdural hematoma ?

Answer 20

associated with a crescent shape , crosses the suture line

Question 21

what is the classic presentation associated with subdural hematoma ?

Answer 21

old age \alcoholics \blood thinners

Question 22

what is the classic injury in shaken baby syndrome ?

Answer 22

subdural hematoma

Question 23

why is old age associated with a higher risk of subdural hematoma ?

Answer 23

brain atrophy increases space veins must cross

Question 24

where is the blood leakage in association with subarachnoid hemorrhage ?

Answer 24

bleeding into space between arachnoid and pia mater

Question 25

what is the classic presentation associated with subarachnoid hemorrhage ?

Answer 25

worst headache of my life sudden onset of symptoms fever , neck pain

Question 26

what is seen on spinal tap of a subarachnoid hemorrhage ?

Answer 26

xanthochromia

Question 27

what are the main disorders associated with subarachnoid hge ?

Answer 27

APKD margans disease Ehlers - Danlos

Question 28

what is the most common cause of intrcranial bleeds ?

Answer 28

charcot bouchard microaneurysms usually associated with chronic hypertenson

Question 29

what is the most common artery associated with ischemic strokes ?

Answer 29

middle cerebral artery\usually affecting the putamen

Question 30

what is cerebral amyloid angiopathy ?

Answer 30

recurrent hemorrhagic strokes associated with beta amyloid deposits in the artery wall

Question 31

what is the common scenario associated with cerebral amyloid angiopathy ?

Answer 31

associated with recurrent hemorrhagic strokes in elderly people

Question 32

what are the causes of intraventricular hemorrhage ?

Answer 32

complication of premature birth hemorrhage occurs into the lateral ventricle

Question 33

what are the complications associated with intraventricular hemorrhage ?

Answer 33

can obstruct the foramen of monro along with affection of the germinal matrix

Question 34

what is the treatment for intraventricular hemorrhage ?

Answer 34

VP shunt