Neurosurgery notes/Vascular/Haemorrhagic diseases

Haemorrhagic diseases

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Parent item
Vascular
Sub-item
Intraventricular haemorrhage
Intracerebral haemorrhage (ICH)
SAH
Features
ICH
Ischaemic
Clinical progression
Slow progression to maximal neurological deficit
Maximal neurological deficit at onset
Clinical symptom
Severe H/A (most often 1st symptoms), vomiting and alterations in consciousness
Cloud 2023 et al
  • RCT
    • Low dose Aspirin
    • Placebo
  • Above 70s
  • 38% increase of haemorrhagic stroke or subdural, extradural, and subarachnoid bleeding
  • No difference in incidence of ischemic stroke
Low does aspirin and risk of stroke and intracerebral bleeding in healthy older people
Low does aspirin and risk of stroke and intracerebral bleeding in healthy older people
  • Rebleeding risk after 1st bleed around 4%
  • Cerebral blood flow is maintained at a constant rate between mean arterial pressures of 50 - 150 mmHg  BUT IT IS 10mmg Higher for cerebral prefusion pressure 60-160mmHg
Neurosurg Focus 26 (5):E4, 2009 Cavernous carotid aneurysms: to treat or not to treat? CHRISTOPHER S. EDDLEMAN, M.D., PH.D., MICHAEL C. HURLEY, M.D.,BERNARD R. BENDOK, M.D., AND H. HUNT BATJER, M.D. Departments of Neurological Surgery and Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Neurosurg Focus 26 (5):E4, 2009 Cavernous carotid aneurysms: to treat or not to treat? CHRISTOPHER S. EDDLEMAN, M.D., PH.D., MICHAEL C. HURLEY, M.D.,BERNARD R. BENDOK, M.D., AND H. HUNT BATJER, M.D. Departments of Neurological Surgery and Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Algorithm for determining revascularization procedures in cases in which parent artery occlusion is required
Intervention
Selection Criteria
PAO w/out bypass
BTO†: no evidence of failure to tolerate occlusion;
SPECT: no perfusion abnormality
PAO w/ low-flow bypass (EC-IC)
BTO: no evidence of failure to tolerate occlusion on angiography or clinically during normotensive condition; failure to tolerate occlusion on clinical testing in hypotensive state, w/ or w/out abnormal EEG changes;
SPECT: no perfusion abnormality
PAO w/ high-flow bypass (vein or radial artery)
BTO: failure to tolerate occlusion in all tests;
SPECT: asymmetrical perfusion
Saccular (Berry) Aneuryms of the Circle of Willis
Saccular (Berry) Aneuryms of the Circle of Willis