Classification of Intracerebral Hemorrhage
Features: Sudden onset of headache, focal deficits, and signs of increasing ICP
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IPH: ganglionic
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IPH: lobar
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Subarachnoid
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SITE
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Basal ganglia, thalamus, pons, deep cerebellum
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Cerebral lobes
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Base of brain, convexities
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USUAL CAUSE
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Hypertensive vascular disease
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Various (malformation, coagulopathy, etc)
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Berry aneurysm, AVM
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OUTCOME
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Often lethal
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variable
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Often lethal, acute vasospasm, chronic hydrocephalis
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Parenchymal Brain Injury presentations:
TYPE
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CLINICAL FEATURES
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CHARACTERISTICS
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Concussion
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Transient loc.
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Mild DAD?
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Contusion
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LOC +/- deficits
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Intact Pia-Arachnoid, frontal/temporal poles, lateral temporal
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Laceration
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LOC + deficits
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Torn Pia-Arachnoid
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Diffuse Axonal Damage
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Prolonged LOC
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Tearing of axons in CC, long tracts
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Traumatic Vascular Injury
KIND
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SOURCE
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CLINICAL FEATURES
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CAUSES
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Epidural hematoma
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Dural arteries
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LOC, then silent interval
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Skull fracture
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Subdural hematoma
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Bridging veins
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Acute, subacute, chronic
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Trauma can be mild; brain atrophy, coagulopathy
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Subarachnoid/ intraparenchymal hematoma
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Parenchymal laceration
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Variable
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Variable, usually severe trauma
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Diffuse vascular injury
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Shearing of axons and vessels
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Similar to DAD
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Similar to DAD
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