What is the most common underlying cause of a subarachnoid haemorrhage?
Berry aneurysm in the circle of willis
A patients presents to a & e with a sudden onset headache which she says is "the worst pain ever" She is also vomiting and is drowsy.
What is the gold standard investigation to do in a subarachnoid haemmorhage?
What might you see on the fundoscopy of a patient with a subarachnoid haemmorhage?
Papillodema due to raised ICP
What will a LP show in subarachnoid haemorrhage?
Frank blood that fails to clear
What is the treatment for a patient who has a had a subarachnoid haemmorhage to prevent re bleeding?
Endovascular interventional radiology
What drug is used in subarachnodi haemorrhage that is thought to reduce early morbidity caused by ischaemia?
Nimodipine - calcium channel blocker
What can happen is you do an LP on a patient with hydrocephalus?
Coning (Brain stem become sucked into spinal cord) which can be fatal due to depression of cardiorespiratory centres.
What is an intracerebral haemorrhage?
Bleeding into the brain parenchyma
What are most intracerebral haemorrhages due to?
What do you call microaneurysms caused by hypertension?
Charcot Bouchard aneurysms
Where is the most common site for charcot bouchard aneurysms to form?
Vessels going to the basal ganglia
A patient presents to a & e which right sided facial weakness. They also have a headacke and seem drowsy. What investigations should you perform first?
A patient presents to a & e which right sided facial weakness. They also have a headacke and seem drowsy. You suspect that an underlying vascular problem is causing this. You do a CT scan, what other investigation would you want to do?
Angiography to look for underlying vascular anomaly
A patient presents to a & e which right sided facial weakness. They also have a headacke and seem drowsy. This is their CT scan. What is the diagnosis?
Intracerebral haemorrhage, causing a stroke
What is the treatment of an intracerebral haemmorhage?
Surgical evacuation of the haemoatoma +/- treatment of any underlying abnormality
How do you get an intraventricular haemorrhage?
When there is a rupture of a subarachnoid or intracerebra bleed into a ventricle