Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
103 Cards in this Set
- Front
- Back
|
Bite Care
Dog |
Antibiotic - amoxicillin/clavulanate (augmentin)
Common Bacteria: (Pasteurella, Eikenella corrodens, Streptococcus, Staphylococcus and anaerobes) Tetanus prophylaxis Rabies immunizaton |
|
|
What are beta lactam/beta lactamase antibiotics
|
Penicillins
Cephalosporins Carbapenems |
|
|
Bite care
Cats |
amoxicillin/clavulanate
Common bacteria: Pasteurella species |
|
|
Bite care
Human |
The most common organisms found in infected human bites are Streptococcus anginosis,
(1) closed-fist injury, (2) chomping injury to the finger, (3) puncture-type wounds about the head TMP/SMX plus clindamycin is an acceptable alternative in the penicillin-allergic patient Staphylococcus aureus, Eikenella corrodens, Fusobacterium and Prevotella species. Beta-lactamase-producing bacteria may be detected from human bite infections. |
|
|
MRSA
|
distinguish MRSA colonization from infection
Community acquired Tx - Oral cephalosporin or if resistant trimethoprim/sulfamethoxazol Hospital acquired Tx - IV - vancomycin HCL |
|
|
Hypovolemic Shock
|
Hypoperfusion w/ low/declining BP
Loss of volume - Hemorrhage Treat underlying cause - Give fluids Crystalloids (NS or Lactated Ringers) Colloid (blood) If refractory -> vasopressors |
|
|
Cardiogenic Shock
|
Pump failure
Vascular disorders Cardiac dysrhythmia |
|
|
Distributive
|
Spepsis
Anaphylaxis Intoxications |
|
|
Obstructive
|
Tension Pneumothorax
Pericardial tamponade/constrictive pericarditis Massive pulmonary embolus Severe pulmonary hypertension Severe valvular stenosis |
|
|
Migraine Headache
|
chronic, genetically determined, episodic, neurologic disorder.
Key Factors TX: Triptans, antiemetics presence of risk factors prolonged headache nausea decreased ability to function headache worse with activity sensitivity to light sensitivity to noise aura Other Factors vomiting unilateral throbbing sensation obesity |
|
|
Cluster Headaches
|
severe pain localized to the unilateral orbital, supraorbital and/or temporal areas; lasts from 15 minutes to 3 hours. Occurs from once every other day to 8 times per day.
May be precipitated by alcohol, nitrates or vasodilation. presence of risk factors repeated attacks of pain excruciating pain lacrimation, rhinorrhea and partial Horner's syndrome agitation TX: Greater occipital nerve blockade subcutaneous sumatriptan Oxygen episodic/chronic cluster headache calcium-channel blocker divalproex sodium gabapentin melatonin lithium topiramate refractory episodic cluster headache methylergonovine episodic/chronic cluster headache refractory to all other therapies surgery |
|
|
Tension Headaches
|
episodic or chronic
Not actually driven by muscular tension Bilateral generalized head pain frontal head pain nonpulsatile head pain occipital pain constricting pain photophobia phonophobia mild nausea pericranial tenderness stress Other Factors previous regular analgesic use sternocleidomastoid muscle tenderness trapezius muscle tenderness temporalis muscle tenderness lateral pterygoid muscle tenderness masseter muscle tenderness normal neurologic examination depression somatization TX: tricyclic antidepressants muscle relaxants nondrug therapies |
|
|
Clear C-Spine
|
NEXUS cervical spine criteria
1: Normal level of consciousness 2: No painful distracting injuries 3: No evidence of intoxication 4: No posterior midline cervical tenderness 5: No focal neuroligic deficits |
|
|
Pre-eclampsia
|
Diagnosed if hypertension (BP >140/90 mmHg) and proteinuria of more than 300 mg/24 hours during the third trimester of pregnancy.
Seizures reflect progression to eclampsia, TX: magnesium sulfate - Start presumptively at onset of seizure, and continue until 24 hours post-partum BP greater than 160/110 mmHg requires medical therapy with antihypertensives (hydralazine) |
|
|
Gestational hypertension or pregnancy-induced hypertension
|
defined as the development of new arterial hypertension in a pregnant woman after 20 weeks gestation.
Pre-eclampsia and eclampsia are sometimes treated as components of a common syndrome. Hypertension can arise before week 20 if the woman has multiple fetuses or a hydatidiform mole |
|
|
Types of high blood pressure in pregnancy
|
1) chronic hypertension, 2) preeclampsia-eclampsia, 3) preeclampsia superimposed on chronic hypertension, and 4) gestational hypertension (transient hypertension of pregnancy or chronic hypertension identified in the latter half of pregnancy) After 20 weeks.
160 mm Hg or DBP greater than 110 mm Hg denotes severe disease |
|
|
Treatment of high blood pressure in pregnancy
|
magnesium sulfate reduces risk of eclampsia in patients with preeclampsia
Hydralazine, methyldopa Not good evidence for salt restriction Bed rest is recommended |
|
|
Delirium
|
Delirium is an acute and relatively sudden (developing over hours to days) decline in attention-focus, perception, and cognition. Usually organic origin and often reversible if cause identfied and treated
|
|
|
Dementia
|
(meaning "deprived of mind") is a serious cognitive disorder. Usually have normal level of consciousness. It may be static, the result of a unique global brain injury or progressive, resulting in long-term decline in cognitive function due to damage or disease in the body beyond what might be expected from normal aging.
Normally must be present for at least 6 months |
|
|
Psychosis
|
literally means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"
|
|
|
Differential Dx for pyschosis
|
Differential Diagnosis: Psychiatric Conditions
Schizophrenia Schizophreniform Disorder Psychotic for >1 month and <6 months Schizoaffective Psychosis for 1 month with concurrent Mood Disorder No Alcohol Dependence Delusional disorder Delusions without hallucinations for 1 month No Alcohol Dependence Brief psychotic disorder Psychotic episode <1 month Shared psychotic disorder Folie a deux Major Depression Psychotic depression Drug resistant depression Borderline Personality disorder Differential Diagnosis: Organic Conditions Drug Induced Psychosis (medications or Substance Abuse) Electrolyte disturbance Hyponatremia Hypercalcemia Hypocalcemia Hypomagnesemia Hypoglycemia Sepsis Hepatic Encephalopathy Delirium Dementia Tic Disorder Huntington's Chorea |
|
|
Coma cocktail
|
Dextrose
Oxygen Naloxone Thiamine |
|
|
AEIOU TIPS
Altered level of consciousness differential |
Alcohol
Endocrine, Electrolytes, Encephalopathy Insulin O2 Uremia Toxidromes, Trauma, Temperature Infection Psych, Porphyria, Pharmacy Stroke, Sepsis, Subarchnoid bleed, Space occupying lesion |
|
|
SIG E CAPS
Depression Screening |
Sleep changes
Interest loss Guilt Energy loss Cognition, concentration Appetite Psychomotor changes Suicide |
|
|
Cushing's Reflex
|
Elevated BP, Widening pulse pressure, Slow heart rate - may indicate ICP
|
|
|
Unilateral dilated pupil
|
indicates brain herniation until proven otherwise. Usually ipsilateral.
|
|
|
Recognize hyperthermia
|
Hyperthermia is defined as elevated core temperature >38.5°C. Heat stroke core temp >40.5C
Heat illness should be thought of as a spectrum of disease from heat cramps to heatstroke. Conditions such as malignant hyperthermia and neuroleptic malignant syndrome need to be specifically recognized, as the treatment of these diseases requires adjunctive pharmacotherapy (dantrolene) |
|
|
Treat Hyperthermia
|
Evaporative cooling
Ice water immersion Whole body ice packing Gastric lavage Peritoneal lavage Antipyretics are not effective in treating environmental hyperthermia. Use intravenous fluids modestly in the setting of hypotension and hyperthermia to avoid worsening pulmonary edema. Cooling is the treatment of choice to cause peripheral vasoconstriction and reduce venous pooling. Consider using short-acting benzodiazepines to reduce agitation and shivering during initial cooling as well as to treat hyperthermia due to sympathomimetic ingestion. Coagulopathy is a common physiologic response to hyperthermia; be sure to monitor for disseminated intravascular coagulopathy (DIC). Consider a trial of glucose in any patient with altered mental status. Avoid rapid replacement of free water, as hyponatremia and cerebral edema may develop. |
|
|
types of abdominal pain
|
Visceral: dull, poorly localized, midline
Parietal: Sharp, constant localized, aggravated by movement Referred: T9 pneumonia, subscapular billiary, testicular-uretal |
|
|
Acute Abdomen Questions
|
Where is pain
Radiate How began How long what is it feel like 0-10 scale palliative ever before Nausea, vomiting, anorexia, constipation, diarrhea, bleeding, Dysuria, *Menses, Vag, Testes,, gyn Hx Cough, dyspnea, CP PMH |
|
|
Abdominal Exam - Order of operations
|
Inspection
Auscultation Percussion Palpation - Flex the knees to relax muscles! Guarding, rebound tenderness |
|
|
What is Murphy's sign
|
Abrupt end to inspiration during palpation of RUQ
|
|
|
PE Maneuvers for appendicitis
|
Rebound tenderness (not nice)
Psoas sign Obturator sign Rovsing's sign (RUQ pain when LLQ palpated |
|
|
every male with abdominal pain
|
gets a genital exam
|
|
|
Every woman of child bearing age with abdominal pain
|
gets a pelvic exam
|
|
|
What percentage of elderly patients presenting in the ED w/ abdominal pain eventually need surgery
|
40% !!!!!!!!!!!!!!!!
|
|
|
LFT's
elevated AST |
Normal 8-40 IU/L
Liver injury acute or chronic hepatitis, obstructive jaundice, AMI, skeletal muscle dz (AST > ALT by 3-5X or more), hemoytic anemia, gallstone pancreatitis |
|
|
LFT's
Decreased AST or ALT |
Pregnancy
|
|
|
LFT's
Elevated ALT |
Normal value 8-45, 6-38
Normal 8-45, 6-38 Hepatocellular injury, Large myocardial injury skeletal muscle dz (AST > ALT by 3-5X or more), gallstone pancreatitis Drugs inducing liver injury |
|
|
LFT's
Elevated GGT |
Obstructive jaundice,
Normal 11-49, 7-32 Hepatitis Cirrhosis METS-liver pancreatitis Elevated in 70% of alcoholic liver dz |
|
|
LFT's
Decreased GGT |
Normal 11-49, 7-32
Exercise, Pregnancy Hypothyroidism |
|
|
LFT's
Elevated ALK |
Normal 30-130
Billiary tract obstruction METS liver Primary billiary cirrhosis drug induced hepatitis increased bone turnover |
|
|
LFT's
Decreased ALK |
Normal 30-130
Pregnancy Blood transfusion |
|
|
LFT's
Elevated bilirubin |
total 0.3-1.1
Direct 0-0.2 Liver or billiary tract dz Decrease would be lab error |
|
|
LFT's
Elevated LDH |
Normal 100-212
Hemolytic anemia malignancies acute hepatits MI Shock ... |
|
|
LFT's in common bile duct dz
|
AST & ALT will rise then ALK and bilirubin.
|
|
|
LFT's in alcoholic liver dz
|
AST:ALT is about 3:1
|
|
|
Uper GI bleed Dx
|
diagnosis suspected based on hematemesis, 'coffee-ground' emesis, melena or anemia
diagnosis confirmed with esophagogastroduodenoscopy (diagnostic tool of choice for evaluation of lesions above ligament of Treitz)(1,3) upper gastrointestinal source unlikely if nasogastric suctioning produces bile but no blood(1) presence of ≥ 2 factors (age < 50 years, history of black stool, BUN/creatinine ≥ 30) may reliably predict upper gastrointestinal source of bleeding complete blood count (CBC) electrolytes/glucose level blood urea nitrogen (BUN)/creatinine coagulation studies (prothrombin time/international normalized ratio [INR], partial thromboplastin time [PTT]) liver function tests nasogastric tube placement electrocardiogram (ECG) endoscopy C-13 urea test (H. pylori) |
|
|
Pancreatitis Sx
|
Severe, dull epigastric or LUQ pain, radiate to back
|
|
|
Pancreatitis Signs
|
Abd tenderness
Abd, distention Volume depreciation |
|
|
Suspected pancreatitis w/u
|
Amylase
Lipase Abdominal CT, with contrast |
|
|
Vomiting Tx
|
Supportive
Fluids IV if dehydrated Ondansetron (zofran) Promethazine (phenergen) P6 acupoint massage |
|
|
Four sub-types of dizziness
|
1) Vertigo - illusion of movement
2) Near syncope = feeling faint 3) Disequilibrium - disrupted sensory - motor which unsteady the gait. 4) Psychophysiologic dizziness |
|
|
Testing for vertigo/izziness
|
Cranial Nerves
Romberg Gait Orthostatics Hallpike test -> Epley maneuver Head-thrust test (saccade=vestibular) Henneberts test Hyperventilation |
|
|
Limits of a FAST ultrasound exam
|
Does not typically identify source of bleeding,
or detect injuries that do not cause hemoperitoneum Requires extensive training to assess parenchyma reliably Limited in detecting <250 cc intraperitoneal fluid Particularly poor at detecting bowel and mesentery damage (44% sensitivity) Difficult to assess retroperitoneum Limited by habitus in obese patients |
|
|
Advantage of a Diagnostic Peritoneal Lavage
|
Good at detecting intraperitoneal bleeding, GI contents, bile in the unstable patient
|
|
|
What is in the primary survey?
|
Primary survey and resuscitation
A = Airway and cervical spine B = Breathing C = Circulation and haemorrhage control D = Dysfunction of the central nervous system E = Exposure |
|
|
What is in the secondary survey?
|
Has Head/skull
My maxillofacial Critical Cervical spine Care Chest Assessed Abdomen Patient’s Pelvis Priorities Perineum Or Orifices Next Neurological Management Musculoskeletal Decision? Diagnostics/definitive care AMPLE questions added |
|
|
Posturing, 3 and 2 on Glasgow Coma Scale
|
3 = Flexion/decorticate
2 = Extension/Decerebrate w/ internal rotation of feet |
|
|
Signs of basilar skull fx
|
Battles sign - behind ears
Racoons signs - under eyes CSF otorrhea/rhinorrhea w/ halo sign |
|
|
Differentiate pneumothorax from hemothorax
|
Percussion of affected side
|
|
|
SSx of pneumothorax
|
Spontaneous-tall thin 20-40 male > female
Secondary - smokers, emphysema, asthma, pneumocystis Decreased breath sounds Hyperreasonance SubQ emphysema |
|
|
SSx of tension pneumothorax
|
Cyanosis
Air hunger Distended juglulars Tracheal displacement toward injured side Emphysema - SubQ Absent breath sounds injured side Percussion hypereasonant Shocky - skin cold and clammy, hypotensive |
|
|
Hemo - tension - Pneumothorax Tx
|
needle thoracotomy
tube thoracotomy |
|
|
Fever of Unknown Origin
|
fever > 38C at least twice a week for more than three weeks. Unsuccessful w/u.
Sinusitis is frequent cause. Respiratory Dental Urinary Unusual bacteria QUESTION: what may have casued host vulnerability what pathogens are usually involved what is in local/travel community what exposure based on habits does the pt have |
|
|
Causes of Fever in the post op patient
|
Six Ws
Wind, atelectasis secondary to intubation/anestesis Water, UTI Wound, infection Walking, phlebitis or DVT Wonder drugs (common causes) Women, endometritis, mastitis |
|
|
Describe general features of seizures:
Grand mal tonic clonic absence febrile |
Generalized Seizures
(Produced by the entire brain) Symptoms 1. "Grand Mal" or Generalized tonic-clonic Unconsciousness, convulsions, muscle rigidity 2. Absence Brief loss of consciousness 3. Myoclonic Sporadic (isolated), jerking movements 4. Clonic Repetitive, jerking movements 5. Tonic Muscle stiffness, rigidity 6. Atonic Loss of muscle tone |
|
|
TX: grand mal
no confirmed eeg but 2 or more GTCS episodes: |
Lamotrigine, topiramate, oxcarbazepine...valproic acid
Monotherapy and combo |
|
|
TX: Partial Sz
partial seizures with secondary generalization, EEG or MRI suggestive of partial epilepsy with 2 or more unprovoked GTCSs |
Valproic acid
Lamotrigine, topiramate, oxcarbazepine Mono then combo |
|
|
Tx:Generalized
idiopathic generalized epilepsy with 2 or more unprovoked GTCSs, findings on EEG or MRI suggestive of idiopathic generalized epilepsy |
Valproic acid
Lamotrigine, topiramate, oxcarbazepine Mono then combo |
|
|
Tx: abscence Sz
|
Ethosuximide or valproic acid or lamotrigine
|
|
|
Glasgow Coma Scale
Eye opening |
4 Spontaneous
3 To voice 2 To pain 1 No response |
|
|
Glasgow Coma Scale
Verbal Response |
5 Oriented
4 Confused conversation 3 Inappropriate words 2 Incomprehensible sounds 1 No Response |
|
|
Glasgow Coma Scale
Motor response |
6 Follows commands
5 Localizes pain 4 Withdraws from pain 3 Abnormal Flexion - Decorticate 2 Abnormal Extension - Decerebrate 1 No response |
|
|
Glasgow Coma Scale
Critical score |
8 or less is coma
|
|
|
Acute alcohol Withdrawal
|
Benzodiazepines remain the cornerstone of treatment.
Vitamin supplementation Treat persistent HTN & tachycardia w/ beta blockers Treat major w/d & DT w/ butyhenone (haloperidol) Treat Sz w/ anticonvulsants |
|
|
Acute pericarditis
|
Sudden sharp retroseternal pain w/ a friction rub.
Treat underlying d/o Infection w/ antibiotics Inflammation w/ high dose NSAIDs refractory w/ colchicine and different NSAID IF TB the treat that |
|
|
MI - STEMI
|
ST elevation myocardial infarction
ST elevation in two or more anatomical contiguous EKG leads: II, III and aVF == Inferior leads CK-MB and cardiac specific troponins confirm diagnosis I, aVL, V5, V6== Lateral leads V1, V2 ======= Septal leads V3, V4 ======= Anterior leads |
|
|
MI - STEMI Treatment
|
M-orphine
O-xygen N-itrogylcerine A-spirin Cath Lab! If unstable emergent revascularization, inotrope support or IABP (intra aortic balloon pump) Ongoing post-STEMI * antiplatelet therapy * ACE inhibitors * beta blockers * statins |
|
|
MI - NSTEMI
|
Non-ST elevation myocardial infarction
Part of acute coronary syndrome spectrum. Result of a transient or near-complete occlusion of a coronary artery. Patients typically present with chest pressure/discomfort lasting at least several minutes, accompanied by sweating, dyspnea, nausea and/or anxiety. ECG is first-line investigation in all patients and should not be delayed for history, examination or other tests. Does not always necessitate immediate revascularization. Stratified according to risk/benefit for treatment with early coronary angiography and revascularization. Early medical management includes aspirin, a thienopyridine (usually clopidogrel), heparin, a glycoprotein IIb/IIIa inhibitor, a beta-blocker and a statin. Complications are progression or worsening of MI, heart failure, cardiogenic shock, arrhythmias and death. |
|
|
MI- NSTEMI Tx
|
MONA +beta blockers
invasive approach planned 1st percutaneous coronary intervention (PCI) plus anticoagulation plus GP IIb/IIIa inhibitors plus antiplatelet therapy A loading dose of clopidogrel is given as soon as possible on admission and then a maintenance dose is given for up to 1 year.8[A] Evidence Evidence invasive approach not planned 1st antiplatelet therapy plus anticoagulation |
|
|
What does SLUDGE indicate
|
Cholinergic poisoning
S-alivation L-acrimation U-rination D-efecation G-astric E-mptying |
|
|
Signs of anti-cholinergic poisoning
|
ANTI-SLUDGE or
blind as a bat, mad as a hatter, hot as a hare, looney as a toon, red as a beet, dry as a bone |
|
|
Toxic syndromes that may show up on a KUB xray
|
C-hlora hydrate, calcium carbonate
H-eavy metals I-ron, iodinated compounds P-sychotropics, potassium, packets of drugs ES-Enteric coated, slow release formulations |
|
|
Lab tests for toxic ingestions
|
Urine hcG - pregnancy
Chem panel ->electrolytes BUN, creatinine, glucose |
|
|
Calculate Anion Gap
|
Na- (Cl + bicarbonate)
|
|
|
Toxin involved in anion gap metabolic acidosis;
|
M-ethanol, metformin
U-remia D-iabetic ketoacidosis P-araldehyde, phenformin I-ron, isoniazid L-actic acidosis E-thylene glycol C-yanide, carbon monoxide A-lcoholic ketoacidosis T-oulene S-alicylates, seizure |
|
|
Antidote for:
APAP-acetaminophen |
N-acetylcysteine
|
|
|
Antidote for:
ASA |
non symptomatic - observe + psych
symptomatic mild 1st hospital admission + supportive care If deliberate self-harm or suicidal intent is a concern, patient should be referred for psychiatric evaluation once medically cleared. adjunct GI tract decontamination - Considered of limited benefit unless activated charcoal can be given within the first hour after acute ingestion of nonenteric-coated salicylate products. [4] * Primary Options As serious CNS effects are often more prominent with chronic salicylate poisoning, these patients usually require ICU management. Hydration should be addressed and any electrolyte abnormalities corrected as soon as possible. Seizures can be terminated by giving benzodiazepines. plus serum and urinary alkalinization The mainstay of treatment for patients with moderate-to-severe clinical signs and symptoms is alkaline diuresis induced by giving intravenous sodium bicarbonate. Alkalinization of both the serum and urine helps to eliminate salicylates by promoting salicylate ionization. Ionized salicylates cannot be reabsorbed into the renal tubules (thus increasing urinary excretion of salicylates) or cross the blood-brain barrier (thus decreasing CNS salicylate concentration). [9] |
|
|
Antidote for:
Betablockers |
Glucagon
|
|
|
Antidote for:
Organophosphates |
Atropine
Pralidoxime |
|
|
Antidote for:
TCA's |
Sodium bicarbonate and hypertonic saline
|
|
|
Antidote for:
Benzodiazepines |
Flumazenil
|
|
|
Treatment of Atrial fibrillation
|
Several medications were efficacious in conversion of AF and subsequent maintenance of sinus rhythm. Calcium-channel blockers and beta-blockers were more efficacious than digoxin in controlling ventricular rate during exercise in subjects with AF
|
|
|
Tx of adult UTI -uncomplicated
|
TMP-SMX 160/800 PO bid 3 days
Cipro Levo |
|
|
Tx of adult UTI -Complicated
|
Levofloxacin 250mg PO q24 10-14 days
Ciprofloxacine XR 500mg PO q24 10-14 days |
|
|
STD - presumptive chlymidia tx
|
# Primary Options
* azithromycin : 1 g orally as a single dose * doxycycline : 100 mg orally twice daily for 7 days |
|
|
STD - presumptive gonorrhea tx
|
uncomplicated gonococcal infections in adults or children >45 kg
# ceftriaxone : 125 mg intramuscularly as a single dose * urethritis, cervicitis and proctitis * cephalosporins * azithromycin * fluoroquinolones * pharyngitis * ceftriaxone * conjunctivitis * high-dose ceftriaxone |
|
|
STD - PID tx
|
* ceftriaxone : 250 mg intramuscularly as a single dose
and * doxycycline : 100 mg orally twice daily for 14 days |
|
|
Concussion
|
Mild concussions are associated with sequelae. However, a slightly greater injury is associated with both anterograde and retrograde amnesia (inability to remember events before or after the injury). The amount of time that the amnesia is present correlates with the severity of the injury. In all cases the patients develop postconcussion syndrome, which includes memory problems, dizziness, tiredness, sickness and depression. Cerebral concussion is the most common head injury seen in children
|
|
|
Epidural hematoma
|
Epidural hematoma (EDH) is a rapidly accumulating hematoma between the dura mater and the cranium. These patients have a history of head trauma with loss of consciousness, then a lucid period, followed by loss of consciousness. Clinical onset occurs over minutes to hours. Many of these injuries are associated with lacerations of the middle meningeal artery. A "lenticular", or convex, lens-shaped extracerebral hemorrhage will likely be visible on a CT scan of the head. Although death is a potential complication, the prognosis is good when this injury is recognized and treated.
|
|
|
Subdural hematoma
|
Subdural hematoma occurs when there is tearing of the bridging vein between the cerebral cortex and a draining venous sinus. Acute subdural hematomas are usually associated with cerebral cortex injury as well and hence the prognosis is not as good as extra dural hematomas.
Patients may have a history of loss of consciousness but they recover and do not relapse. Clinical onset occurs over hours. A crescent shaped hemorrhage compressing the brain will be noted on CT of the head. Craniotomy and surgical evacuation is required if there is significant pressure effect on the brain.Complications include focal neurologic deficits depending on the site of hematoma and brain injury, increased intra cranial pressure leading to herniation of brain and ischemia due to reduced blood supply and seizures. |
|
|
Subarachnoid hemorrhage
|
bleeding into the subarachnoid space—the area between the arachnoid membrane and the pia mater surrounding the brain
Symptoms of SAH include a severe headache with a rapid onset ("thunderclap headache"), vomiting, confusion or a lowered level of consciousness, and sometimes seizures. The diagnosis is generally confirmed with a CT scan of the head, or occasionally by lumbar puncture |
