Podcast #194: Atruamatic ICH

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/

Episoder(1146)

Podcast #383: Prehospital Tubes

Podcast #383: Prehospital Tubes

Author: Sam Killian, MD Educational Pearls: Two high quality randomized control trials published in 2018 demonstrated no difference in mortality or neurologic outcomes when using a supraglottic ai...

24 Sep 20184min

Podcast #382: Shoulder Separations

Podcast #382: Shoulder Separations

Author: Ryan Circh, MD Educational Pearls: A "shoulder separation" is when the clavicle separates from the scapula - also referred to as an acromio-clavicular (AC) separation Diagnosis is clinic...

21 Sep 20183min

Podcast #381: MRI... Burns?

Podcast #381: MRI... Burns?

Author: Sam Killian, MD Educational Pearls: MRI machines can generate enough heat from the radiofrequency to cause thermal burns Patients with EKG stickers, medication patches, clothing impregna...

19 Sep 20183min

Podcast #380: Oxygen for the kill

Podcast #380: Oxygen for the kill

Author: Ryan Circh, MD Educational Pearls: Review of 25 randomized control trials encompassing 16,037 acutely ill hospitalized patients Patients given oxygen with saturations > 94% on room air wer...

17 Sep 20183min

Podcast #379: Patient Perspectives of the Flu

Podcast #379: Patient Perspectives of the Flu

Author: Sam Killian, MD Educational Pearls: Patients may have certain fears or expectations about the flu based on hearsay and other less reliable sources Taking extra time explaining the risks ...

14 Sep 20184min

Podcast #378: Is That a Brown Recluse Spider Bite?

Podcast #378: Is That a Brown Recluse Spider Bite?

Author: Michael Hunt, MD Educational Pearls: Use the mnemonic NOT RECLUSE to rule out a brown recluse spider bite: Numerous bites (recluse spiders will bite once) Occurence (recluse bites betw...

12 Sep 20184min

Podcast #377: Endocarditis

Podcast #377: Endocarditis

Author: Nick Tsipis, MD Educational Pearls: Persistent fever or positive blood cultures should raise suspicion for endocarditis Patients with recent dental procedures, recent cardiac surgeries a...

10 Sep 20183min

Podcast #376: Alcohol Intoxication

Podcast #376: Alcohol Intoxication

Educational Pearls: Blood concentrations over 0.4 mg/dL is associated with respiratory depression and possible death in alcohol naive patients Alcohol overdose accounts to 2,200 deaths per year ...

8 Sep 20184min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
jss
rss-rekommandert
liberal-halvtime
villmarksliv
forskningno
rss-paradigmepodden
sinnsyn
fjellsportpodden
rss-nysgjerrige-norge
vett-og-vitenskap-med-gaute-einevoll
nevropodden
diagnose
smart-forklart
dekodet-2
abid-nadia-skyld-og-skam
tidlose-historier
nordnorsk-historie