TAILIEUCHUNG - Practical management in stroke (Fourth edition): Part 2

(BQ) Continued part 1, part 2 of the document Practical management in stroke (Fourth edition) has contents: Wha t caused this subarachnoid hemorrhage, a prac tical approach to the management of stroke and transient ischemic attack, specific treatment of acute ischemic stroke, specific treatment of aneurysmal subarachnoid hemorrhage,. and other contents. Invite you to refer. | 437 9 What caused this subarachnoid hemorrhage Matthew B. Maas and Andrew M. Naidech Department of Neurology Northwestern University Chicago IL USA CHAPTER MENU Basic overview of subarachnoid hemorrhage 437 Mechanisms of subarachnoid bleeding 438 Neuroimaging patterns and findings 443 Personal and genetic influences on subarachnoid hemorrhage 447 Examination features in patients with subarachnoid hemorrhage 449 Investigative course 450 Basic overview of subarachnoid hemorrhage Anatomic overview A basic grasp of the anatomy of the brain and its vascular supply is crucial to understanding the pathophysiology of bleeding in different intracranial compartments. The brain surface and skull are separated by three layers of membranes or meninges. The pia is a thin membrane directly adherent to the brain surface and the dura is adherent to the skull surface. The arachnoid adheres to the inner surface of the dura. Although the space between the pia and brain the dura and skull and the arachnoid and dura are only potential spaces with no separation under normal circumstances the subarachnoid space that lies between the arachnoid and pia is filled with cerebrospinal fluid. In addition the major cerebral arteries and their large branches travel in the subarachnoid space only entering the brain tissue in the form of small penetrating arterioles. Thus subarachnoid hemorrhage SAH occurs either from a source vessel traveling in the subarachnoid space or when a hemorrhage that originates in brain tissue dissects through the thin pia membrane and into the subarachnoid space. Similarly rupture of subarachnoid arteries may cause intraparenchymal extension with development of an intracerebral hemorrhage simultaneously with SAH again because the pia provides little mechanical barrier support. In the second section of this chapter we will review the multiple specific conditions and mechanisms that lead to SAH. Subarachnoid hemorrhage occurs either from a

• Y khoa - Dược
• Warlow’s stroke
• Aneurysmal subarachnoid hemorrhage
• Acute ischemic stroke
• Specific treatment
• Transient ischemic attack
• A prac tical approach