Intracranial hematomas - Revision history

Michael: /* Microscopic */

2014-12-09T07:14:14Z

Microscopic

← Older revision		Revision as of 07:14, 9 December 2014
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	*Blood in subdural (potential) space.		*Blood in subdural (potential) space.

	Images:		====Images====
	*[http://commons.wikimedia.org/wiki/File:Subdural_hematoma_-_very_low_mag.jpg SDH - very low mag. (WC)].		<gallery>
	*[http://commons.wikimedia.org/wiki/File:Subdural_hematoma_-_intermed_low_mag.jpg SDH - intermed. mag. (WC)].		Image:Subdural_hematoma_-_very_low_mag.jpg \| SDH - very low mag. (WC)
			Image:Subdural_hematoma_-_intermed_low_mag.jpg \| SDH - intermed. mag. (WC)
			</gallery>

	==Subarachnoid hematoma==		==Subarachnoid hematoma==

Michael: /* General */

2013-12-24T17:23:42Z

General

← Older revision		Revision as of 17:23, 24 December 2013
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	*+/-Trauma.		*+/-Trauma.
	*Elderly, esp. those with cerebral atrophy.<ref>{{Ref PCPBoD8\|663}}</ref>		*Elderly, esp. those with cerebral atrophy.<ref>{{Ref PCPBoD8\|663}}</ref>

			Recurrance risks:
			*[[Diabetes mellitus]].<ref name=pmid22653496>{{Cite journal \| last1 = Chon \| first1 = KH. \| last2 = Lee \| first2 = JM. \| last3 = Koh \| first3 = EJ. \| last4 = Choi \| first4 = HY. \| title = Independent predictors for recurrence of chronic subdural hematoma. \| journal = Acta Neurochir (Wien) \| volume = 154 \| issue = 9 \| pages = 1541-8 \| month = Sep \| year = 2012 \| doi = 10.1007/s00701-012-1399-9 \| PMID = 22653496 }}</ref>

	===Gross===		===Gross===

Michael: w

2013-04-11T11:05:14Z

← Older revision		Revision as of 11:05, 11 April 2013
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	'''Intracranial ~~hematomas~~''', also '''intracranial hemorrhage''', are bad stuff that keep neurosurgeons busy. They are usually diagnosed by imaging (CT head).		'''Intracranial [[hematoma]]s''', also '''intracranial hemorrhage''', are bad stuff that keep neurosurgeons busy. They are usually diagnosed by imaging (CT head).

	Not much bleeding is needed to cause death. In a person without atrophy (to provide space for the blood) ~75 ml is considered enough if it is acute.<ref>McAuliffe. 15 October 2010.</ref>		Not much bleeding is needed to cause death. In a person without atrophy (to provide space for the blood) ~75 ml is considered enough if it is acute.<ref>McAuliffe. 15 October 2010.</ref>

Michael: /* Gross */

2012-05-06T18:02:29Z

Gross

← Older revision		Revision as of 18:02, 6 May 2012
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	DDx - medical imaging:		DDx - medical imaging:
	*[[Diffuse axonal injury]].<ref name=pmid22406792>{{Cite journal \| last1 = Kumar \| first1 = S. \| last2 = Gupta \| first2 = V. \| last3 = Aggarwal \| first3 = S. \| last4 = Singh \| first4 = P. \| last5 = Khandelwal \| first5 = N. \| title = Fat embolism syndrome mimicker of diffuse axonal injury on magnetic resonance imaging. \| journal = Neurol India \| volume = 60 \| issue = 1 \| pages = 100-2 \| month = \| year = \| doi = 10.4103/0028-3886.93597 \| PMID = 22406792 }}</ref>		*[[Diffuse axonal injury]]<ref name=pmid22406792>{{Cite journal \| last1 = Kumar \| first1 = S. \| last2 = Gupta \| first2 = V. \| last3 = Aggarwal \| first3 = S. \| last4 = Singh \| first4 = P. \| last5 = Khandelwal \| first5 = N. \| title = Fat embolism syndrome mimicker of diffuse axonal injury on magnetic resonance imaging. \| journal = Neurol India \| volume = 60 \| issue = 1 \| pages = 100-2 \| month = \| year = \| doi = 10.4103/0028-3886.93597 \| PMID = 22406792 }}</ref> - severe DAI classically has a corpus callosum injury.
	*Herpes simplex encephalitis - temporal lobe hemorrhage.		*Herpes simplex encephalitis - temporal lobe hemorrhage.

Michael: /* Cerebral fat embolism */

2012-05-06T18:01:11Z

Cerebral fat embolism

← Older revision		Revision as of 18:01, 6 May 2012
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	DDx - medical imaging:		DDx - medical imaging:
	*[[Diffuse axonal injury]].<ref name=pmid22406792>{{Cite journal \| last1 = Kumar \| first1 = S. \| last2 = Gupta \| first2 = V. \| last3 = Aggarwal \| first3 = S. \| last4 = Singh \| first4 = P. \| last5 = Khandelwal \| first5 = N. \| title = Fat embolism syndrome mimicker of diffuse axonal injury on magnetic resonance imaging. \| journal = Neurol India \| volume = 60 \| issue = 1 \| pages = 100-2 \| month = \| year = \| doi = 10.4103/0028-3886.93597 \| PMID = 22406792 }}</ref>		*[[Diffuse axonal injury]].<ref name=pmid22406792>{{Cite journal \| last1 = Kumar \| first1 = S. \| last2 = Gupta \| first2 = V. \| last3 = Aggarwal \| first3 = S. \| last4 = Singh \| first4 = P. \| last5 = Khandelwal \| first5 = N. \| title = Fat embolism syndrome mimicker of diffuse axonal injury on magnetic resonance imaging. \| journal = Neurol India \| volume = 60 \| issue = 1 \| pages = 100-2 \| month = \| year = \| doi = 10.4103/0028-3886.93597 \| PMID = 22406792 }}</ref>
			*Herpes simplex encephalitis - temporal lobe hemorrhage.

	~~Image~~:		Images:
	*[http://www.duke.edu/~ema5/Golian/Slides/3/fluids-hemo_files/flh212.jpg FE (duke.edu)].<ref>URL: [http://www.duke.edu/~ema5/Golian/Slides/3/fluids-hemo.htm http://www.duke.edu/~ema5/Golian/Slides/3/fluids-hemo.htm]. Accessed on: 25 March 2012.</ref>		*[http://www.duke.edu/~ema5/Golian/Slides/3/fluids-hemo_files/flh212.jpg FE (duke.edu)].<ref>URL: [http://www.duke.edu/~ema5/Golian/Slides/3/fluids-hemo.htm http://www.duke.edu/~ema5/Golian/Slides/3/fluids-hemo.htm]. Accessed on: 25 March 2012.</ref>
			*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132375/figure/F2/ Cerebral fat embolism (nih.gov)].<ref>{{Cite journal \| last1 = Eriksson \| first1 = EA. \| last2 = Schultz \| first2 = SE. \| last3 = Cohle \| first3 = SD. \| last4 = Post \| first4 = KW. \| title = Cerebral fat embolism without intracardiac shunt: A novel presentation. \| journal = J Emerg Trauma Shock \| volume = 4 \| issue = 2 \| pages = 309-12 \| month = Apr \| year = 2011 \| doi = 10.4103/0974-2700.82233 \| PMID = 21769222 \| PMC = 3132375}}</ref>

	===Microscopic===		===Microscopic===

Michael: /* Intracerebral hematoma */

2012-05-04T13:43:00Z

Intracerebral hematoma

← Older revision		Revision as of 13:43, 4 May 2012
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	Causes:<ref>{{Ref PCPBoD8\|665}}</ref>		Causes:<ref>{{Ref PCPBoD8\|665}}</ref>
	*[[Hypertension]] - usually putamen, thalamus, pons, cerebellum - see ''[[hypertension#Intracerebral_hematoma\|intracerebral hematoma in hypertension]]''.		*[[Hypertension]] - usually putamen, thalamus, pons, cerebellum - see ''[[hypertension#Intracerebral_hematoma\|intracerebral hematoma in hypertension]]''.
	*[[Cerebral amyloid angiopathy]].		*[[Cerebral amyloid angiopathy]] - usually superficial (cortex & subcortical white matter) & frontal lobe or parietal lobe.<ref name=pmid17297004>{{Cite journal \| last1 = Haacke \| first1 = EM. \| last2 = DelProposto \| first2 = ZS. \| last3 = Chaturvedi \| first3 = S. \| last4 = Sehgal \| first4 = V. \| last5 = Tenzer \| first5 = M. \| last6 = Neelavalli \| first6 = J. \| last7 = Kido \| first7 = D. \| title = Imaging cerebral amyloid angiopathy with susceptibility-weighted imaging. \| journal = AJNR Am J Neuroradiol \| volume = 28 \| issue = 2 \| pages = 316-7 \| month = Feb \| year = 2007 \| doi = \| PMID = 17297004 \| URL = http://www.ajnr.org/content/28/2/316.long }}</ref>
	*[[Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy]] (CADASIL).<ref name=pmid17135568>{{Cite journal \| last1 = Choi \| first1 = JC. \| last2 = Kang \| first2 = SY. \| last3 = Kang \| first3 = JH. \| last4 = Park \| first4 = JK. \| title = Intracerebral hemorrhages in CADASIL. \| journal = Neurology \| volume = 67 \| issue = 11 \| pages = 2042-4 \| month = Dec \| year = 2006 \| doi = 10.1212/01.wnl.0000246601.70918.06 \| PMID = 17135568 }}</ref>		*[[Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy]] (CADASIL).<ref name=pmid17135568>{{Cite journal \| last1 = Choi \| first1 = JC. \| last2 = Kang \| first2 = SY. \| last3 = Kang \| first3 = JH. \| last4 = Park \| first4 = JK. \| title = Intracerebral hemorrhages in CADASIL. \| journal = Neurology \| volume = 67 \| issue = 11 \| pages = 2042-4 \| month = Dec \| year = 2006 \| doi = 10.1212/01.wnl.0000246601.70918.06 \| PMID = 17135568 }}</ref>

Michael: /* General */

2012-05-04T13:37:34Z

General

← Older revision		Revision as of 13:37, 4 May 2012
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	===General===		===General===
	Causes:<ref>{{Ref PCPBoD8\|665}}</ref>		Causes:<ref>{{Ref PCPBoD8\|665}}</ref>
	*[[Hypertension]].		*[[Hypertension]] - usually putamen, thalamus, pons, cerebellum - see ''[[hypertension#Intracerebral_hematoma\|intracerebral hematoma in hypertension]]''.
	*[[Cerebral amyloid angiopathy]].		*[[Cerebral amyloid angiopathy]].
	*[[Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy]] (CADASIL).<ref name=pmid17135568>{{Cite journal \| last1 = Choi \| first1 = JC. \| last2 = Kang \| first2 = SY. \| last3 = Kang \| first3 = JH. \| last4 = Park \| first4 = JK. \| title = Intracerebral hemorrhages in CADASIL. \| journal = Neurology \| volume = 67 \| issue = 11 \| pages = 2042-4 \| month = Dec \| year = 2006 \| doi = 10.1212/01.wnl.0000246601.70918.06 \| PMID = 17135568 }}</ref>		*[[Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy]] (CADASIL).<ref name=pmid17135568>{{Cite journal \| last1 = Choi \| first1 = JC. \| last2 = Kang \| first2 = SY. \| last3 = Kang \| first3 = JH. \| last4 = Park \| first4 = JK. \| title = Intracerebral hemorrhages in CADASIL. \| journal = Neurology \| volume = 67 \| issue = 11 \| pages = 2042-4 \| month = Dec \| year = 2006 \| doi = 10.1212/01.wnl.0000246601.70918.06 \| PMID = 17135568 }}</ref>

Michael: /* General */

2012-03-25T18:20:16Z

General

← Older revision		Revision as of 18:20, 25 March 2012
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	*In the [[forensic pathology\|forensic]] context ''SAH'' alone is not good enough.		*In the [[forensic pathology\|forensic]] context ''SAH'' alone is not good enough.
	**One needs to determine the cause, e.g. ruptured [[berry aneurysm]] ''or'' laceration of left vertebral artery.		**One needs to determine the cause, e.g. ruptured [[berry aneurysm]] ''or'' laceration of left vertebral artery.

			DDx:
			*Trauma - most common, see section below.
			*Ruptured [[berry aneurysm]] ~80% of non-traumatic SAH.<ref>{{Cite journal \| last1 = Ingelmo Ingelmo \| first1 = I. \| last2 = Fàbregas Julià \| first2 = N. \| last3 = Rama-Maceiras \| first3 = P. \| last4 = Hernández-Palazón \| first4 = J. \| last5 = Rubio Romero \| first5 = R. \| last6 = Carmona Aurioles \| first6 = J. \| title = [Subarachnoid hemorrhage: epidemiology, social impact and a multidisciplinary approach]. \| journal = Rev Esp Anestesiol Reanim \| volume = 57 Suppl 2 \| issue = \| pages = S4-15 \| month = Dec \| year = 2010 \| doi = \| PMID = 21298906 }}
			</ref>
			*[[Arteriovenous malformation]] and other vascular anomalies.

	====Traumatic SAH====		====Traumatic SAH====

Michael: /* Subdural hematoma */ +images

2012-03-25T05:29:05Z

Subdural hematoma: +images

← Older revision		Revision as of 05:29, 25 March 2012
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	Features:		Features:
	*Blood in subdural (potential) space.		*Blood in subdural (potential) space.

			Images:
			*[http://commons.wikimedia.org/wiki/File:Subdural_hematoma_-_very_low_mag.jpg SDH - very low mag. (WC)].
			*[http://commons.wikimedia.org/wiki/File:Subdural_hematoma_-_intermed_low_mag.jpg SDH - intermed. mag. (WC)].

	==Subarachnoid hematoma==		==Subarachnoid hematoma==

Michael: /* Epidural hematoma */ expand, add note about artefactual--- in fire

2012-03-25T05:27:07Z

Epidural hematoma: expand, add note about artefactual--- in fire

← Older revision		Revision as of 05:27, 25 March 2012
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	*Patient may have lucid interval.<ref name=pmid8319240>{{cite journal \|author=Erşahin Y, Mutluer S, Güzelbag E \|title=Extradural hematoma: analysis of 146 cases \|journal=Childs Nerv Syst \|volume=9 \|issue=2 \|pages=96–9 \|year=1993 \|month=April \|pmid=8319240 \|doi= \|url=}}</ref>		*Patient may have lucid interval.<ref name=pmid8319240>{{cite journal \|author=Erşahin Y, Mutluer S, Güzelbag E \|title=Extradural hematoma: analysis of 146 cases \|journal=Childs Nerv Syst \|volume=9 \|issue=2 \|pages=96–9 \|year=1993 \|month=April \|pmid=8319240 \|doi= \|url=}}</ref>
	*Classically due to an injury of the ''middle meningeal artery''.		*Classically due to an injury of the ''middle meningeal artery''.
	*~~Usu.~~ due to trauma.		*Usually due to trauma.
			*Generally considered artefactual in the context of [[fire deaths]].<ref name=pmid2309533>{{Cite journal \| last1 = Ritter \| first1 = C. \| title = [A heat gelatinized subdural hematoma in a burned cadaver as an indication of a vital accident]. \| journal = Z Rechtsmed \| volume = 103 \| issue = 3 \| pages = 227-30 \| month = \| year = 1990 \| doi = \| PMID = 2309533 }}</ref>

	===~~Radiology~~===		===Gross===
			*Blood outside of the dura.

			Radiology:
	*Biconvex.		*Biconvex.

			===Microscopic===
			Features:
			*+/-Extravasated [[red blood cell]]s.
			*+/-Hemosiderin-laden macrophages.

	==Subdural hematoma==		==Subdural hematoma==

← Older revision		Revision as of 13:43, 4 May 2012
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	Causes:<ref>{{Ref PCPBoD8\|665}}</ref>		Causes:<ref>{{Ref PCPBoD8\|665}}</ref>
	*[[Hypertension]] - usually putamen, thalamus, pons, cerebellum - see ''[[hypertension#Intracerebral_hematoma\|intracerebral hematoma in hypertension]]''.		*[[Hypertension]] - usually putamen, thalamus, pons, cerebellum - see ''[[hypertension#Intracerebral_hematoma\|intracerebral hematoma in hypertension]]''.
	*[[Cerebral amyloid angiopathy]].		*[[Cerebral amyloid angiopathy]] - usually superficial (cortex & subcortical white matter) & frontal lobe or parietal lobe.<ref name=pmid17297004>{{Cite journal \| last1 = Haacke \| first1 = EM. \| last2 = DelProposto \| first2 = ZS. \| last3 = Chaturvedi \| first3 = S. \| last4 = Sehgal \| first4 = V. \| last5 = Tenzer \| first5 = M. \| last6 = Neelavalli \| first6 = J. \| last7 = Kido \| first7 = D. \| title = Imaging cerebral amyloid angiopathy with susceptibility-weighted imaging. \| journal = AJNR Am J Neuroradiol \| volume = 28 \| issue = 2 \| pages = 316-7 \| month = Feb \| year = 2007 \| doi = \| PMID = 17297004 \| URL = http://www.ajnr.org/content/28/2/316.long }}</ref>
	*[[Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy]] (CADASIL).<ref name=pmid17135568>{{Cite journal \| last1 = Choi \| first1 = JC. \| last2 = Kang \| first2 = SY. \| last3 = Kang \| first3 = JH. \| last4 = Park \| first4 = JK. \| title = Intracerebral hemorrhages in CADASIL. \| journal = Neurology \| volume = 67 \| issue = 11 \| pages = 2042-4 \| month = Dec \| year = 2006 \| doi = 10.1212/01.wnl.0000246601.70918.06 \| PMID = 17135568 }}</ref>		*[[Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy]] (CADASIL).<ref name=pmid17135568>{{Cite journal \| last1 = Choi \| first1 = JC. \| last2 = Kang \| first2 = SY. \| last3 = Kang \| first3 = JH. \| last4 = Park \| first4 = JK. \| title = Intracerebral hemorrhages in CADASIL. \| journal = Neurology \| volume = 67 \| issue = 11 \| pages = 2042-4 \| month = Dec \| year = 2006 \| doi = 10.1212/01.wnl.0000246601.70918.06 \| PMID = 17135568 }}</ref>