Term
| What are the areas affected by HPTN Hemorrhage, presenting symptoms for each area, which has the worst prognosis |
|
Definition
Basal Ganglia:
Hemiparesis,
Lateral ventical bleed
Subcortical White Matter:
Mental Status Change
Thalamus:
Headache
3rd ventricle bleed
Cerebellum:
Risk of Herniation
Compression of 4th ventricle
Pons:
Instant Death/Pin-Point Pupils, Hypothermia, **Worst Prognosis** |
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Term
| How does HPTN cause intracerebral hemorrhage |
|
Definition
Chronic HPTN causes fibrinoid necrosis of small vessels
Penetrating Vessels develop reduced tensile strength of the vessel wall (Charcot-Bouchard Aneurysms)
Transient BP increases cause hemorrhage |
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Term
| Where do brain hemorrhages caused by Amyloid Angiopathy occur, how does it present, and what is the age group |
|
Definition
Subcortical White Matter
Presentation: Alzheimer's-like Dementia
Age Group: >65
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|
|
Term
| How does amyloid angiopathy cause intracerebral hemorrhage |
|
Definition
| Amyloid deposition in media and adventitia weakening vessel wall |
|
|
Term
| What are the major causes of intracerebral hemorrhages |
|
Definition
HPTN
Amyloid Angiopathy
AV malformations
Drug Use
Trauma |
|
|
Term
| What type of hemorrhage is caused by AV malformations |
|
Definition
| Intracerebral or Subarachnoid depending on the location |
|
|
Term
| How do AV malformations typically cause intracranial bleeding |
|
Definition
| Form Aneurysms that evenually rupture |
|
|
Term
| What are the drugs associated with causing intracerebral hemorrhages? |
|
Definition
Sympathomimetic: Cocaine, Amphetimines
Antithrombolytics
IV Drugs: cause mycotic aneurysms from endocarditis |
|
|
Term
| What cerebrovascular pathology is cocaine likely to produce in the elderly and in younger adults |
|
Definition
Elderly: Stroke
Younger Adults: Aneurysms |
|
|
Term
| What is the timeframe and progression of neurological deficits produced by intracerebral hemorrhage |
|
Definition
Abrupt onset
Deficits evolve over 12-24 hrs |
|
|
Term
| How does an intracerebral hemorrhage typically present |
|
Definition
Abrupt onset neurological deficits
Headache, Nausea, Vomiting
High BP from Cushing's Reflex |
|
|
Term
| What are the prognostic indicators for intracerebral hemorrhage and when is treatment indicated? |
|
Definition
Progressive lethargy or coma-> BAD
Size of the hematoma
Treatment is only indicated in large cerebellar hemorrhages |
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|
Term
| What are the major causes of subarachnoid bleeds |
|
Definition
Saccular Aneurysm
Trauma
Vascular Malformations
Mycotic Aneurysms from endocarditis |
|
|
Term
| Where should you look for a subarachnoid bleed on MRI |
|
Definition
|
|
Term
| Where are the most common site for aneurysms |
|
Definition
ACOM, PCOM, MCA
Basilar tip, PICA |
|
|
Term
| What is the presentation of Subarachnoid Hemorrages |
|
Definition
Nausea/Vomiting
Loss of Consciousness
Menigimus-Worst headache of my life
Stiff neck
PCOM->CNIII palsy
MCA->Hemiparesis
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|
|
Term
| What is the treatment for a cerebrovascular aneurysm? |
|
Definition
Clip or coil: elderly should use coil
Prevent Vasospam: fluids, raise BP, nimodipine |
|
|
Term
| What are the complications of aneurysms and what are the treatment options for these complications? |
|
Definition
Vasospasm: Angioplasty
Hydrocephalus: Ventricular drain |
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|
Term
| What is the prognosis for subarachnoid hemorrhages |
|
Definition
Persistant disability
Major Mortality |
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