Various faces of intracranial hemorrhage

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Various faces of intracranial hemorrhage

Post  Abbas on Tue Jun 15, 2010 10:06 pm

Following are 10 types of intracranial hemorrhages that one may encounter in emergency (or in in OSCE Very Happy ). Try to answer. I will post answers to all the questions in this forum when a minimum of 3 responses are given


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Re: Various faces of intracranial hemorrhage

Post  Dr.Hunain(admin) on Wed Jun 16, 2010 8:56 am

For many of them i think i havent come up with the right answer...Embarassed
1.Sub dural hematoma
2. Organized subdural hematoma
3.Extra dural hematoma
4..Sub arachnoid hemorrhage
5.Extra dural hematoma ( in occipital regiont )
6.Intra ventricular hemorrhage
7. Subarachnoid hemorrhage due to catheter for csf drainage
8. Bleed in meningeal cyst?
9.-
10.Air entry into skull cavity due to fracture of skull leading to venous bleed in anterior cranial fossa?

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i tried sir ...

Post  mariumz on Sun Jun 20, 2010 5:20 pm

1) right subdural hematoma with ipsilateral ventricular compression
2)bilateral subacute subdural hematoma
3)right acute epidural haemorrhage with pressure effects
4)subarachoid haemorrhage
5)left occipital extradural heamorrhage
6)right intracerebral parietal haemorrhage
7)right subacute subarachnoid haemorrhage with a patient with a VP shunt in place
8)ring enhancing lesion in an arachnoid cyst?!?!
9)bleed in an arachnoid cyst
10)subdural haematoma with traumatic airspace in frontal region

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Good Attempts

Post  Abbas on Sun Jun 20, 2010 10:12 pm

You and Hunain mostly got them right. One more reply and I will give answers.

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ANSWERS

Post  Abbas on Thu Jul 08, 2010 7:56 pm

OK! The answers, though I could not get the requisite number of replies.

1) Right sided subdural hematoma with midline shift (always mention site in imaging) with ispsilateral lateral ventricle obliteration and opposite temporal horn dilatation (which is an early sign of foramen of monro obstruction)

2) Bilateral large balanced subdural hematomas with no midline shift (preferably don't comment upon obliteration of lateral ventricles as plane seems to pass above its level.

3) Right sided extradural hematoma with pressure effects as indicated by midline shift and relative obliteration of ipsilateral lateral ventricle and dilatation of temporal and anterior horns of opposite side.

4) relative acute subdural hematoma in the process of spilling over from saggital sinus (from where most of these come) and at present confined to fax cerebri, may later spill over to sided. Subarachnoid hemorrhage is not that much contained nor this much sharply defined.

5) left sided parieto-occiptal extradural hemorrhage with some pressure effects (see above for pressure effects)

6) Right sided deep intracerebral hemorrhage in the the region of basal ganaglia (coming usually from penetrating striate arteries in hypertensive subjects) with pressure effects.

7) VP-Shunt in right lateral ventricle with subdural hematoma on the same side. Remember VP shunts by draining hydrocephalus shrink the brain, and if drainage is too vigorous (like in some high flow shunts) subdural hematomas are precipitated. This hematoma once again shows some pressure effects. original hydrocephalus for which shunt was placed has largely drained away with the new found space being occupied by the hematoma.

8 ) A large calcified cyst out of the substance of brain (in subarachnoid space, note thin rim of subdural fluid seperating cyst from skull bone in 3rd film taken in bone window),compressing underlying brain substance. A calcified abcess can also be accepted.

9) Extradural Pneumohematoma (both hematoma and air generally occur in severe fractures of mastoid processes and air cells)

10) Pneumoceles in subdural spaces by fractures of frontal region of skull. Last two CTs are uncommon and primarily for neurosurgery examinations.

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Re: Various faces of intracranial hemorrhage

Post  Dr.Hunain(admin) on Thu Jul 08, 2010 9:14 pm

Thank you for the answers sir, well it was good learning..please keep us updated with different questions and videos if possible....will really be appreciated...:-) bounce

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