Hemorrhagic Stroke

by Carlo Raj, MD

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    Our topic now moves into hemorrhagic stroke. Under hemorrhagic stroke, intracerebral hemorrhage. How did this occur? Was there hypertension, for example You’ve heard of berry aneurysm. Whenever you hear about aneurysm, what are you worried about? With an aneurysm, you’re worried about enough of expansion taking place where a rupture may take place, resulting in a type of hemorrhage. Well, no exception here. And say that your patient has hypertension and you have a berry aneurysm in the anterior portion of the circle of Willis. Maybe the anterior communicating artery. May result in intracerebral hemorrhage. Mass lesions. For example, metastatic lesions. You could have choriocarcinoma. Extremely common in terms of where it metastasizes. So for example, you find your patient to have beta hCG to be elevated, choriocarcinoma, gestational and non-gestational choriocarcinoma. Metastasis unfortunately could be up to the brain. Melanoma to the brain. Thyroid cancer to the brain. Lung to the brain. Renal carcinoma to the brain. This is a beautiful list of differentials. Cancer differentials that commonly, commonly, may have brain metastasis resulting in what? Hemorrhagic type of stroke. Vascular malformations Amyloid angiopathy. Usually, when you hear about amyloid especially up in the brain, you should be thinking about your Alzheimer’s and some of that amyloid, when it starts accumulating in your blood vessel, you call this amyloid angiopathy. At risk for what? Hemorrhagic stroke. Cocaine/amphetamine use. Some of these, you’ll find overlap with ischemic stroke as well. Remember it’s a little fine line, isn’t it? Between an ischemic stroke and then if the blood vessel in fact does rupture, may result in hemorrhagic stroke. It changes the complexion of the stroke clinically, but it could actually be part of a continuum. So keep that in mind. Don’t be so black and white that you think, “Oh, it...

    About the Lecture

    The lecture Hemorrhagic Stroke by Carlo Raj, MD is from the course Stroke (Cerebrovascular Accident). It contains the following chapters:

    • Hemorrhagic Stroke
    • Hemorrhagic Stroke: Summary

    Included Quiz Questions

    1. Charcot Bouchard aneursym
    2. Berry aneurysm
    3. Arterio-venous malformations
    4. Metastatic tumors
    5. Amyloid angiopathy
    1. Subarachnoid bleed causing stroke
    2. Intracerebellar bleed causing stroke
    3. Focal ischemic stroke
    4. Global ischemic stroke
    5. Hypotensive stroke
    1. Glioblastoma multiformae
    2. Renal cell carcinoma
    3. Small cell carcinoma of lung
    4. Papillary carcinoma of thyroid
    5. Non gestational choriocarcinoma
    1. Basal ganglia
    2. Pons
    3. Cerebellum
    4. Hypothalamus
    5. Temporal lobe
    1. Alpha and beta adrenergic receptor blocker
    2. Selective alpha adrenergic receptor blocker
    3. Selective beta adrenergic receptor blocker
    4. Alpha adrenergic receptor agonist
    5. Beta adrenergic receptor agonist
    1. MRI with contrast
    2. MRI without contrast
    3. CT with contrast
    4. CT without contrast
    5. PET scan
    1. MRI without contrast
    2. MRI with contrast
    3. Cerebral angiography
    4. CT without contrast
    5. CT with contrast
    1. Cerebral angiography
    2. MRI without contrast
    3. MRI with contrast
    4. CT without contrast
    5. CT with contrast

    Author of lecture Hemorrhagic Stroke

     Carlo Raj, MD

    Carlo Raj, MD

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    Lots of detail lacking
    By Hamed S. on 16. March 2017 for Hemorrhagic Stroke

    Not sure if there will further talks on haemorrhagic stroke but significant omissions evident. For example target for BP lowering, discussion of management of complications incl vasopasm, raised ICP, seziure prevention. Work up of patient wasn't clear ie the use of lumbar punctures in high clinical suspicions but ct equivocal