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27 Cards in this Set
- Front
- Back
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Intracerebral hemorrhage is defined as bleeding where?
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in the brain parenchyma
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What is "general" presentation of intracerebral hemorrhage?
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"stroke like", with focal deficits
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Most common cause of ICH?
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trauma
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Is deep or lobar ICH more common?
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deep (2/3)
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Most common attributable risk factor for ICH?
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hypertension
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What is the second most common risk factor for ICH?
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cerebral amyloid angiopathy
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What IS cerebral amyloid angiopathy?
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amyloid depositions in cortical arterioles in elderly individuals
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Name drug that can be used in Afib to prevent clots that has less bleeding issues than warfarin?
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dabigatrin
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Name a risk factor for ICH in young people
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drug use
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Is ICH more common is acute cocaine users or former users?
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acute/current
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Describe cerebral reperfusion syndrome
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It happens after carotid revascularization, seen after CEA and angioplasty, due to increased blood flow with impaired autoregulation
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Where in vessels does ICH bleeding usually occur?
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near bifurcation
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How long does hematoma expand in ICH?
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6 hours for non-coagulopathic, 24 hours for coagulopathic
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What does it mean if pt. has ischemic area around hematoma (penumbra area)?
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worse prognosis
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What symptoms raise your suspicion for hemorrhagic vs. ischemic stroke?
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headache, nausea, vomiting, depressed consciousness
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Chronic hematomas look like what on CT?
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hypodense
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What imaging is used to tell if pt. has underlying structural pathology?
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MRI
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Reversible cerebral vasoconstriction is a spectrum of disorders that is characterized by?
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thunderclap headache assoc. with reversible vasoconstriction
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How do you alleviate symptoms in RCVS?
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calcium channel blockers, glucocorticoids, magnesium sulfate, supportive treatment
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llobar bleeds have higher risk of what than deep or ganglionic ones?
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re-bleeding
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Most important modifiable risk factorfor prevention of ICH recurrence?
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blood pressure control
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If pt. is on warfarin, what do you need to treat with?
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vitaminK, FFP, and PCCs(prothrombin complex concentrates)
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Coag related treatment for ICH pt. not on warfarin?
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factor VIIa has been tried but not clinically indicatedright now
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What is the goal systolic BP during ICH?
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less than 160
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Treatment of ICP in ICH?
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Begin by elevating the bed, anelgesia, and sedation
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What is goal CPP in ICH?
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>60 mmHg
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At what GCS do you monitor and treat for ICP?
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<8
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