Vascular Events- Brain bleeds, LPs Flashcards Preview

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Flashcards in Vascular Events- Brain bleeds, LPs Deck (22):
1

MC location of a berry aneurysm

Anterior communicating artery

2

Two dz associated with berry (sacular) aneurysm

1. Autosomal dominant polycystic kidney dz
2. Ehlers-Danlos (NOT marfan)

3

MCC of subarachnoid hemorrhage?

Trauma

4

MCC of subarachnoid hem if not trauma? what is 2nd?

1. Ruptured aneurysm
2. ruptured AVM (arteriovenous malformation)

5

Worst headache of life

subarachnoid hemorrhage

6

workup for "worst HA of life"?

1. non contrast CT (look for blood)
2. LP (look for blood again)

7

what is xanthanchromia, what does it indicate?

Yellowish coloration to CSF due to bilirubin (heme breakdown); indicative of a chronic subarachnoid hemorrhage (if bilirubin present, blood has been there for a while)

8

medical tx for subarachnoid hemorrhage?

Nimodipine--> dihydropyridine CCB; helps prevent vasospasm, which occurs often after a subarach. bleed

9

Sx tx for subarachnoid bleed?

Surgical clip

10

lucid interval

epidural hematoma

11

crescent-shaped on CT

subdural hematoma

12

Charcot-bouchard microaneurysm--> where and what is likely cause?

small lenticulostriate vessels supplying basal ganglia and thalamus, or internal capsule--> HTN MCC
(can also be due to amyloid angiopathy, vasculitis, neoplasm, cocaine, or anticoagulant theapy)

13

pt wakes up fro sleepinf with stroke symptoms due to thrombosis... candidate for tPA?

NO--> only if presents within 4.5 hours; must assume they had it right when went to sleep

14

old person hits their head and present 3 days later with severe headache and vomiting

subdural hematoma--> common in alcoholics too due to cerebral atrophy

15

*What 8 structures (in order) are passed during an LP

1. Skin
2. Superficial fascia
3. 3 ligaments (Supraspinatus, interspinatus, ligamentum flavum)
4. Epidural space
5. Dura mater
6. Arachnoid space
7. Subarachnoid space (where CSF is; where spinal anethesia in given)

16

Where are LPs done

b/n L3-L4 (L3/L4 saves the cord)

*lower in children, because their spinal cord is lower

17

landmark for doing LP

top of iliac crest is level of L4

18

difference b/n stroke and TIA?

TIA symptoms resolve in 24 hrs

19

4 areas most vulnerable to ishemia

1. cerebellum
2. neocortex
3. hippocampus
4. watershed areas

*watershed b/n MCA/ACA and MCA/PCA distribution; usually better off due to anastomosis in occlusion, but in hypotnesion, first to die

20

CT reveals what in stroke workup

If hemorrhagic or not

21

lenticulate or lens shaped (football) on CT

epidural hemotoma

22

What CN lesion is frequently seen with epidural hematoma

CN III palsy--> dilated pupil esp.

*non working pupils without paralysis--> workup for aneurysm

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