Emergency Medical Minute24 Apr 2017

Podcast #194: Atruamatic ICH

Author: Peter Bakes, M.D

Educational Pearls

Intracerebral hemorrhage is an intracranial bleed within the brain tissue or ventricles.
Subarachnoid aneurysm causes about 50% of all ICH.
Amyloid deposition can lead to ICH in elderly patients.
Hypertension is another common cause of atraumatic ICH, commonly leading to pontine, cerebellar, or basal ganglial bleeding. Bleeding in other locations is suggestive of a different etiology.
ICH will often present with depressed mental status, but specifically a patient with a systolic BP > 220 is suggestive of hypertensive ICH.
CT is the first diagnostic step. CTA should be considered when the bleeding is in an atypical area. Significant edema on imaging can be suggestive of a tumor.
Treatment should include hemostatic measures and BP control. Transfuse platelets if necessary and reverse any anticoagulation. BP target is <140 systolic. Monitor ICP if patient has AMS. Neurosurgical intervention is indicated when there is significant expansion of the hematoma with AMS or if the bleed is cerebellar.

References: Sahni R, Weinberger J. Management of intracerebral hemorrhage. Vascular Health and Risk Management. 2007;3(5):701-709. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2291314/

Denne episoden er hentet fra en åpen RSS-feed og er ikke publisert av Podme. Den kan derfor inneholde annonser.

Episoder(1168)

Podcast 1013: Thoracotomy Indications

Contributor; Taylor Lynch, MD Educational Pearls: Thoracotomy Thoracotomy is used in traumatic cardiac arrest to replace conventional CPR with direct access to the chest. Goals include identif...

20 Jul 3min

Podcast 1012: Meth Sedation

Contributor: Aaron Lessen, MD Educational Pearls: Agitated patients who are intoxicated with methamphetamine pose a unique challenge when selecting a sedative to counter their symptoms. Is there ...

13 Jul 1min

Podcast 1011: Creepy Crawlies

Contributor: Meghan Hurley, MD Educational Pearls: What animal is the most lethal to humans? Depending on how we define lethal, and animal, this answer is actually not straight forward. Globall...

6 Jul 7min

Podcast 1010: First Pass Intubation Success

Contributor: Travis Barlock, MD Educational Pearls: First-pass success is critical to limit complications from apnea, hypoxia, and airway trauma. Complication rate for patients intubated on the f...

29 Jun 3min

On the Streets- Zero to Rodeo

Dan Orbidan, OMS-II and Dr. Travis Barlock, MD discuss a real out of hospital call. This episode covers the implications of a pharmacologically abnormal patient presentation and the pre and post hospi...

22 Jun 35min

Carepoint Journal Club- Neurology

Carepoint Journal Club is a quarterly series with discussions about a medical topic, brought to you by Carepoint's Emergency Physicians.

15 Jun 36min

Podcast 1009: Prevention for Recurrent UTI

Contributor: Aaron Lessen, MD Educational Pearls: UTIs are commonly seen in older women We often see them taking long-term prophylactic antibiotics because of common recurrence. Around 20-30% of...

8 Jun 1min

Podcast 1008: Acupuncture for Low Back Pain in Older Adults

Contributor: Aaron Lessen, MD Educational Pearls: Back pain is a common presenting complaint in the emergency department. Challenges arise when tailoring care to elderly populations using standar...

1 Jun 2min