Intracranial Hemorrhages Flashcards
Intracerebral hemorrhage
second most common cause of?
stroke
(ischemic stroke is 1st cause)
Intracerebral hemorrhage
what is associated w/ enlargement of hemorrhage
- neurologic decline
- increased intracranial pressure
Intracerebral hemorrhage
what can edema around focus of hematome do?
delay perfusion due to mass effect, local neuronal ischemia, or accumulation/cytoxic factors
Intracerebral hemorrhage
risk factors for ICH
8
- HTN
- non-compliance w/ meds
- heavy EtOH use
- male gender
- anti-coagulants
- anti-platelets
- illicit drugs
- trauma
Intracerebral hemorrhage
presentation
6
- elevated BP
- focal neurologic deficits
- vomiting
- stupor or coma
- seizures
- cardiac abnormalities
Intracerebral hemorrhage
what would we suspect if sudden and maximal onset of headache?
subarachnoid hemorrhage
Intracerebral hemorrhage
what would we suspect with presentation of:
* stiff neck
* nuchal rigidity
* photophobia
* HA
* intraventricular blood circulating in CSF
meningismus
Intracerebral hemorrhage
immediate work up unstable pt
- intubation/mech ventilation
- anti-coag reversal
- BP control
- neuro consult
Intracerebral hemorrhage
general work up
5
- non-contrast CT to confirm
- Labs: CBC, CMP, PT, INR, troponin, UA, hcg, tox screen
- MRI w/ contrast can help identify underlying cause
- Cerebral angiography for surgical planning
- consider LP to assess for presence of blood
Cerebral Amyloid Angiopathy
describe
- deposition of amyloid beta-peptide within the cerebral vasculature
Cerebral Amyloid Angiopathy
how does this lead to hemorrhage?
- deposition in the cerebral vasculature leads to concentric splitting of the vasculature wall
Cerebral Amyloid Angiopathy
most common clinical manifestation
acute lobar intracerebral hemorrhage
Subdural Hematoma
where is bleeding occuring?
between the dura and arachnoid membranes
Subdural Hematoma
how does this occur?
when bridging vessels between membranes tear during trauma
Subdural Hematoma
what will you see on CT of brain
concave lesions
