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Neuro/Cognition: Hemorrhagic Stroke - Coggle Diagram
Neuro/Cognition: Hemorrhagic Stroke
Etiology/Pathogenesis
Caused by arteriovenous malformation, aneurysm, coagulopathy, vasculitis, illicit drug use
Rupture of a cerebral vessel → blood leaks from the vessel into the brain tissue (hemorrhage) → cerebral edema → compression of brain tissue and spasm of adjacent blood vessels → space occupying lesion forms (hematoma) → increased ICP → decreased cerebral perfusion → infarction of the cerebral tissues
Complications
WORST= death
Coma
Cerebral edema
Increased ICP
Sensory impairment
Loss of cognitive function
Labs/Diagnostics
CT scan will diagnose cerebral hemorrhage
MRI will diagnose ischemic stroke
Collaborative Treatments
Seizure precautions
VTE prophylaxis
BP management
Discontinue all anticoagulation and antiplatelet drugs
Reversal of coagulation with appropriate agent
Antihypertensive medications
Anticonvulsants for recurring seizures
Mannitol to reduce ICP
Manifestations
Initial vomiting
"Worst headache of my life"
Manifestations depend on which vessel and area of the brain is involved- hemorrhage into the basal ganglia will cause contralateral hemiplegia with initial flaccidity that progresses to spasticity
Altered mental status
Seizure
Marked HTN
Possible manifestations include hemiparesis, hemisensory loss, aphasia, neglect
Risk Factors
Advancing age
HTN
Previous hx of stroke
Alcohol abuse
Use of illicit drugs
Bleeding disorders
Male sex
Warfarin use
Brain trauma