Intracranial Bleeds Flashcards
(29 cards)
Around ____% of strokes are caused by intracranial bleeds.
Around 10-20% of strokes are caused by intracranial bleeds.
Q
A
what are the risk factors for intracranial bleeds
Head injury
Hypertension
Aneurysms
Ischaemic stroke can progress to haemorrhage
Brain tumours
Anticoagulants such as warfarin
how might an intracranial bleed present?
Sudden onset headache is a key feature. They can also present with:
Seizures
Weakness
Vomiting
Reduced consciousness
Other sudden onset neurological symptoms
The _____________ is a universal assessment tool for assessing the level of consciousness
Glasgow Coma Scale (GCS)
GCS is based on what?
eyes, verbal and motor response
GCS max and min score?
max: 15/15
min 3/15
When someone has a GCS score of ___/15 or below then you need to consider securing their airway as there is a risk they are not able to maintaining it on their own.
When someone has a score of 8/15 or below then you need to consider securing their airway as there is a risk they are not able to maintaining it on their own.
how is the eyes bit of GCS assessed?
Eyes
Spontaneous = 4
Speech = 3
Pain = 2
None = 1
how is the Verbal bit of GCS assessed?
Verbal response
Orientated = 5
Confused conversation = 4
Inappropriate words = 3
Incomprehensible sounds = 2
None = 1
how is the Motor bit of GCS assessed?
Motor response
Obeys commands = 6
Localises pain = 5
Normal flexion = 4
Abnormal flexion = 3
Extends = 2
None = 1
Subdural haemorrhage is caused by …..
Subdural haemorrhage is caused by rupture of the bridging veins in the outermost meningeal layer. They occur between the dura mater and arachnoid mater
On a CT scan subdural haemorrhages have… what appearance?
On a CT scan they have a crescent shape and are not limited by the cranial sutures (they can cross over the sutures).
Subdural haemorrhages occur more frequently in who? and why?
Subdural haemorrhages occur more frequently in elderly or alcoholic patients.
These patients have more atrophy in their brains making vessels more likely to rupture.
Extradural haemorrhage is usually caused by ……
Extradural haemorrhage is usually caused by rupture of the middle meningeal artery in the temporo-parietal region
extradural haemorrhages are associated with?
It can be associated with a fracture of the temporal bone.
gradual haemorrhages bleeding occurs where?
It occurs between the skull and dura mater
on a CT scan an extradural haemorrhage looks like what?
On a CT scan they have a bi-convex shape and are limited by the cranial sutures (they can’t cross over the sutures).
typical history for an extradural haemorrhage? how do the symptoms progress?
The typical history is a young patient with a traumatic head injury that has an ongoing headache. They have a period of improved neurological symptoms and consciousness followed by a rapid decline over hours as the haematoma gets large enough to compress the intracranial contents.
Intracerebral haemorrhage involves bleeding into ….
Intracerebral haemorrhage involves bleeding into the brain tissue.
Intracerebral haemorrhage involves bleeding into the brain tissue. It presents similarly to an ….
ischaemic stroke.
where can intracerebral haemorrhage be seen
Anywhere in brain tissue:
Lobar intracerebral haemorrhage
Deep intracerebral haemorrhage
Intraventricular haemorrhage
Basal ganglia haemorrhage
Cerebellar haemorrhage
intracerebral haemorrhages can occur due to:
They can occur spontaneously or as the result of bleeding into an ischaemic infarct or tumour or rupture of an aneurysm.
Subarachnoid haemorrhage involves bleeding in to the …..
Subarachnoid haemorrhage involves bleeding in to the subarachnoid space, where the cerebrospinal fluid is located, between the pia mater and the arachnoid membrane.
