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/

Avsnitt(1146)

Podcast # 431: Medication Errors

Podcast # 431: Medication Errors

Author: Rachel Brady, MD Educational Pearls: Medication errors are estimated to be the 3rd leading cause of death A 2016 study estimated 250,000 errors occur per year, with 7000-9000 leading to death...

4 Feb 20193min

Podcast # 430: Humeral IO

Podcast # 430: Humeral IO

Author: Aaron Lessen, MD Educational Pearls: Choose the longest needle for the humeral IO Internally rotate and adduct the patients hand (resting on umbilicus) for best access to the site Aim 1 cm su...

30 Jan 20193min

Podcast # 429: Oldschool Syphilis Treatment

Podcast # 429: Oldschool Syphilis Treatment

Author: Chris Holmes, MD Educational Pearls: In WWI, the 2nd leading cause of soldier disability were STDs. An early treatment of syphilis included topical and inhaled mercury Bloodletting, vitriol, ...

28 Jan 20194min

Podcast # 428: Severe Hypothyroidism

Podcast # 428: Severe Hypothyroidism

Author: Gretchen Hinson, MD Educational Pearls: Clinical manifestations of severe hypothyroidism may include: Pale, cool, diaphoretic skin Myxedema is the non-pitting edema seen in hypothyroidism Hy...

27 Jan 20193min

Podcast # 427: Cookie Dough is Delicious

Podcast # 427: Cookie Dough is Delicious

Author: Eric Miller, MD Educational Pearls: Recent CDC statement warms against consumption of cookie dough Two common ingredients can pose risk: eggs and flour Flour in dough is a raw agricultural ...

24 Jan 20192min

Podcast # 426: Ho Ho - Oh No!

Podcast # 426: Ho Ho - Oh No!

Author: Katrina Iverson, MD Educational Pearls: The winter holiday months present a unique picture of patient presentations to the emergency department Some of the unique presentations include: Chi...

22 Jan 20192min

Podcast # 425: Oseltamivir Efficacy in Children

Podcast # 425: Oseltamivir Efficacy in Children

Author: Aaron Lessen, MD Educational Pearls: Recent meta-analysis reviewed efficacy oseltamivir (Tamiflu) in pediatric populations treated for influenza, showing an 18 hour reduction in duration of i...

18 Jan 20193min

Podcast # 424: Hunting for Measles

Podcast # 424: Hunting for Measles

Author: Mike Hunt, MD Educational Pearls: Measles is highly contagious and successfully infects 90% of those at risk exposed to the virus. 10 day prodrome where patients are asymptomatic. 3 day perio...

16 Jan 20194min

Populärt inom Vetenskap

dumma-manniskor
svd-nyhetsartiklar
p3-dystopia
kapitalet-en-podd-om-ekonomi
allt-du-velat-veta
rss-ufo-bortom-rimligt-tvivel
det-morka-psyket
rss-vetenskapsradion
sexet
medicinvetarna
rss-vetenskapsradion-2
rss-experimentet
pojkmottagningen
dumforklarat
hacka-livet
rss-spraket
bildningspodden
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
rss-lara-fran-larda-en-fackbok-och-en-forfattare
intergalaktiskt