Difference between revisions of "Intracranial hematomas"
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==Classification== | ==Classification== | ||
===By location=== | |||
# Epidural hemorrhage (extradural hemorrhage). | # Epidural hemorrhage (extradural hemorrhage). | ||
#* Patient may have lucid interval.<ref name=pmid8319240>{{cite journal |author=Erşahin Y, Mutluer S, Güzelbag E |title=Extradural hematoma: analysis of 146 cases |journal=Childs Nerv Syst |volume=9 |issue=2 |pages=96–9 |year=1993 |month=April |pmid=8319240 |doi= |url=}}</ref> | #* Patient may have lucid interval.<ref name=pmid8319240>{{cite journal |author=Erşahin Y, Mutluer S, Güzelbag E |title=Extradural hematoma: analysis of 146 cases |journal=Childs Nerv Syst |volume=9 |issue=2 |pages=96–9 |year=1993 |month=April |pmid=8319240 |doi= |url=}}</ref> | ||
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# Intracerebral hemorrhage. | # Intracerebral hemorrhage. | ||
#* > 60 ml at presentation (assessed via CT scan) assoc. with > 90% 30 day mortality.<ref>URL: [http://stroke.ahajournals.org/cgi/content/abstract/24/7/987 http://stroke.ahajournals.org/cgi/content/abstract/24/7/987]. Accessed on: 2 September 2010.</ref> | #* > 60 ml at presentation (assessed via CT scan) assoc. with > 90% 30 day mortality.<ref>URL: [http://stroke.ahajournals.org/cgi/content/abstract/24/7/987 http://stroke.ahajournals.org/cgi/content/abstract/24/7/987]. Accessed on: 2 September 2010.</ref> | ||
===By vessel type=== | |||
*Arterial - common. | |||
*Venous - rare (~3-4 cases/1,000,000 people/year<ref name=pmid19344306>{{cite journal |author=Agostoni E, Aliprandi A, Longoni M |title=Cerebral venous thrombosis |journal=Expert Rev Neurother |volume=9 |issue=4 |pages=553–64 |year=2009 |month=April |pmid=19344306 |doi=10.1586/ern.09.3 |url=}}</ref> | |||
==Subarachnoid hemorrhage== | ==Subarachnoid hemorrhage== |
Revision as of 21:43, 12 October 2010
Intracranial hematomas are bad stuff that keep neurosurgeons busy. They are usually diagnosed by imaging (CT head).
Classification
By location
- Epidural hemorrhage (extradural hemorrhage).
- Patient may have lucid interval.[1]
- Middle meningeal artery.
- Radiology: biconvex.
- Subdural hemorrhage
- Damaged bridging veins: subdural space between the dura and arachnoid mater.[2]
- Radiology: crescent shape.
- Subarachnoid hemorrhage.
- Classically caused by aneuryms:[3]
- Anterior communicating artery (ACA) - most common.
- Middle cerebral artery (MCA) - second most common.
- Classically caused by aneuryms:[3]
- Intracerebral hemorrhage.
- > 60 ml at presentation (assessed via CT scan) assoc. with > 90% 30 day mortality.[4]
By vessel type
- Arterial - common.
- Venous - rare (~3-4 cases/1,000,000 people/year[5]
Subarachnoid hemorrhage
- Abbreviated SAH.
Traumatic SAH
- May have a characteristic mastoid contusion.
- May be associated with vascular Ehlers-Danlos syndrome.
Cerebellar white mater predominant petechial hemorrhage
- AKA brain purpura.
- Etiology: fat embolism syndrome secondary to trauma.
- Image: FE (med.utah.edu).
See also
References
- ↑ Erşahin Y, Mutluer S, Güzelbag E (April 1993). "Extradural hematoma: analysis of 146 cases". Childs Nerv Syst 9 (2): 96–9. PMID 8319240.
- ↑ Crooks DA (1991). "Pathogenesis and biomechanics of traumatic intracranial haemorrhages". Virchows Arch A Pathol Anat Histopathol 418 (6): 479–83. PMID 2058082.
- ↑ Beck J, Rohde S, Berkefeld J, Seifert V, Raabe A (January 2006). "Size and location of ruptured and unruptured intracranial aneurysms measured by 3-dimensional rotational angiography". Surg Neurol 65 (1): 18–25; discussion 25–7. doi:10.1016/j.surneu.2005.05.019. PMID 16378842.
- ↑ URL: http://stroke.ahajournals.org/cgi/content/abstract/24/7/987. Accessed on: 2 September 2010.
- ↑ Agostoni E, Aliprandi A, Longoni M (April 2009). "Cerebral venous thrombosis". Expert Rev Neurother 9 (4): 553–64. doi:10.1586/ern.09.3. PMID 19344306.