Intracranial Haemorrhage Flashcards Preview

Neurology: Headaches and Epilepsy COPY > Intracranial Haemorrhage > Flashcards

Flashcards in Intracranial Haemorrhage Deck (24)
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1

What are the 3 types of intracranial haemorrhage?

Subarachnoid Haemorrhage
Intracerebral Haemorrhage
Intraventricular Haemorrhage

2

What is subarachnoid haemorrhage?

Bleeding into the subarachnoid space

3

What is the usual cause of a subarachnoid haemorrhage?

berry aneurysm

4

Symptoms of subarachnoid haemorrhage?

Sudden onset severe headache
Collapse
Vomiting
Neck pain
Photophobia

5

Name the 3 main differentials of a sudden onset headache?

Subarachnoid Haemorrhage
Migraine
Benign coital cephalgia

6

Sigsn of subarachnoid haemorrhage?

Decreased conscious level
Focal neurological deficit (dysphasia, hemiparesis, IIIrd n. palsy)

7

SAH signs on fundoscopy?

retinal or vitreous haemorrhage

8

In SAH, when may CT scan be negative?

May be negative if >3days post ictus
Negative in 15% of patients who have bled

9

What will a lumbar puncture help differentiate SAH from?

from ‘traumatic tap’

10

What will CSF be like in SAH?

bloodstained or xanthochromic CSF

11

When may lumbar puncture not be safe?

focal symptoms
papilloedema

12

What technique is used in Cerebral Angiography?

Seldinger technique

13

Complications of SAH?

Re-bleeding
Delayed ischaemic deficit
Hydrocephalus
Hyponatraemia
Seizures

14

What is hydrocephalus?

Increased intracranial CSF pressure, often asymptomatic

15

What may symptoms of hydrocephalus be?

Increasing headache or altered conscious level

16

Treatment of hydrocephalus?

CSF drainage - LP, EVD, Shunt

17

Treatment of hyponatraemia/ SIADH?

Do not fluid restrict
supplement sodium intake
fludrocortisone

18

What is Intracerebral Haemorrhage?

Bleeding into brain parenchyma
50% of time due to hypertension, may also be due to aneurysm or arteriovenous malformation

19

In hypertensive ICH, what arises on small perforating arteries?

‘Charcot- Bouchard’ microaneurysms
Basal ganglia haematoma

20

Presentation of ICH?

Headache
Focal neurological deficit
Decreased conscious level

21

Investigations of ICH?

CT scan - urgent if decreased conscious level
Angiography if suspicion of underlying vascular anomaly

22

Treatment of ICH?

Surgical evacuation of haematoma +/-treatment of underlying abnormality

23

What is the name for rupture of a subarachnoid or intracerebral bleed into a ventricle?

intraventricular haemorrhage - any combination of subarachnoid, intracerebral and intraventricular haemorrhage can occur

24

What drugs can cause spontaneous intracranial haemorrhage?

warfarin, heparin