
Management of Pneumothorax
play_arrow Management of Pneumothorax Dr Swapnil Pawar Written by – Dr Andrew Lam FAST scan View Cavity Assessed Findings Subxiphoid Pericardial Assessing for anechoic (dark) fluid between the visceral and […]
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Management of Subarachnoid Hemorrhage (SAH)
Dr Swapnil Pawar
Subarachnoid Haemorrhage
Written by – Dr Andrew Lam
Types of Intracranial Haemorrhage
Type of Haemorrhage | Location | Affected Vessel | Clinical Presentation | CT Findings |
Epidural | Superficial to dura mater | Middle meningeal artery | Usually traumatic in nature with an associated skull fracture. A patient may be initially unconscious from the head strike, recover with a lucid period and then lose consciousness again due to rapid arterial bleed. | Convex (lens-like) hyperdensity |
Subdural | Between dura and pia mater | Bridging veins | Usually in older patients with associated brain atrophy. Can present acutely, subacutely or chronically. | Concave hyperdensity |
Subarachnoid | Subarachnoid space | Berry aneurysms | Sudden onset (thunderclap) headache, sometimes associated with focal neurological deficits. | Hyperdensity in the sulci and basal cisterns (star sign) |
Intracerebral | Brain parenchyma | Small penetrating arteries | Sudden onset stroke-like symptoms with the focal neurological deficit – often in patients with uncontrolled hypertension | Intra-parenchymal hyperdensity |
CT Findings of Subarachnoid Haemorrhage
Types of Herniation
Herniation | Site of Herniation | Symptoms |
Uncal Herniation | Herniation of uncus through the tentorial notch | Fixed dilated ipsilateral pupil (CN III Compression)
Decreased LOC (Reticular Formation Compression) Hemiplegia (Crus Cerebri Compression) |
Subfalcine Herniation | Herniation of cingulate gyrus under the falx cerebri | Behavioural changes and lower limb hemiparesis/sensory loss (Anterior Cerebral Artery Compression) |
Tonsillar Herniation | Herniation of cerebellar tonsils through foramen magnum | Autonomic instability, respiratory arrest and ultimately death (Midbrain Compression) |
References
El-Feky, M., Gaillard, F. (2021). Subarachnoid haemorrhage Radiopaedia. Retrieved February 26, 2021 from https://radiopaedia.org/articles/subarachnoid-haemorrhage
Nickson, C. (2021). Brain Herniation • LITFL • CCC. Retrieved 26 February 2021, from https://litfl.com/brain-herniation/
Tenny S, Thorell W. Intracranial Hemorrhage. [Updated 2020 Jun 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470242/
Dr Swapnil Pawar March 7, 2021
play_arrow Management of Pneumothorax Dr Swapnil Pawar Written by – Dr Andrew Lam FAST scan View Cavity Assessed Findings Subxiphoid Pericardial Assessing for anechoic (dark) fluid between the visceral and […]
Dr Swapnil Pawar April 11, 2021
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