Strengthen your understanding of the intraparenchymal hemorrhage, extradural hemorrhage and subdural hemorrhage. Read this blog for a quick overview of the topic.
Also, stay tuned to our blog and enhance your NEET PG exam preparation by covering all the high-yield topics in medicine.
Bleeding into the brain parenchyma proper is referred to as Intraparenchymal hemorrhage.
BROCA’S area damage
↓Fluency Syntax (Grammar) Expression Motor aphasia
Comprehension lost Receptive Dysphasia Word Salad Fluency is Preserved Jargon Speech
A 50 year old, HTN (non-compliant with medications) comes with the chief C/O → Facial asymmetry and sudden onset → Aphasia and weakness in right arm/shoulder
Provisional diagnosis – LMCA Territory stroke O/E → DTR are Brisk and Babinski sign (+). Non-cooperative with Fundus examination
Door to CT scan time <20 min
Control of HTN Crisis :> 220/130 – IV Nicardipine
Control of Raised ICP → Ventriculostomy
Warfarin ++ → I.P.H.
Prothrombin complex concentrate is superior to FFP in warfarin induced Hemorrhage.
Middle meningeal artery is the source bleeding
NCCT heads shows lenticular hyperdensity
Mass effect of CNS bleed leads to obstructive Hydrocephalus
Lucid interval [consciousness between 2 periods of unconsciousness] may be present.
Rx of EDH with Posturing
Decision for which side to Perform Burr hole is based on
CT Scan Report
I/L mid dilated pupil, sluggish ® to reaction
On the left side if pupils are equivocal in response to light.
SDH- Subdural hemorrhage
Source of bleeding: Cortical bridging veins
70 yr male → Obese, T2 DM, Slipped in Bathroom 7 days back → Bump on head (Subperiosteal Bleeding) + C/O Focal deficit and Arm weakness.
People prone to SDH → Stunt actor/ Boxer/ Mixed martial arts
Diabetic neuropathy patients
Acute SDH shows → Concavo-convex hyperdensity
Chronic SDH shows → After 2-3 weeks hypodensity is there - Black pockets in white blood collection are there due to reabsorption of the blood.
Festinating gait. Sensory ataxia later on gradual onset of neurological symptoms. O/E: Fundus shows Papilledema - DTR are Brisk and Babinski sign is elicited. This is the typical history given in exams regarding the chronic SDH.
The Sx intervention in these cases is not required in all cases and is dependable on ICH score:
ICH Score components
Volume of bleed
Location of bleed
Important Information ● If the patient is >75 yr old and GCS is < 8. volume of bleed > 30 cc and is infratentorial bleed then in these worst scenarios the requirement of Sx intervention is must for management of the patient.
In other cases where the patient does not have the components mentioned above and got mild neurological deficit then the patient is managed conservatively by:-
Get access to all the essential resources required to ace your medical exam Preparation. Stay updated with the latest news and developments in the medical exam, improve your Medical Exam preparation, and turn your dreams into a reality!