#subarachnoidhemorrhage #AnatomicalCorrelation #drnajeeblectures
Subarachnoid Hemorrhage Anatomical Correlation Clinical Features And Pathophysiology
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▬▬▬▬▬▬▬▬▬▬ Contents of this video ▬▬▬▬▬▬▬▬▬▬
Subarachnoid Hemorrhage Anatomical Correlation Clinical Features And Pathophysiology
Sub-Arachnoid Hemorrhage-Anatomical Correlation and Pathophysiology
A comparison of all 4 types of cranial hemorrhages is made in terms of their respective anatomical locations;
Epidural/Extradural Hemorrhage (EH); between the bony skull and Dura. Subdural Hemorrhage (SH); between the Dura and Arachnoid layer. Sub Arachnoid Hemorrhage (SAH); In Sub Arachnoid space mixed with CSF. Intracranial Hemorrhage (ICH) inside the brain.
Development of SAH is caused by spontaneous rupture of Berry Aneurysms (sac-like dilatation of arterial wall) in any of the major vessels of Circle of Willis such as Anterior Cerebral Artery (ACA), Internal Carotid Artery (ICA), Middle Cerebral Artery (MCA) etc.
A brief review of major arterial circulation of the brain in terms of Circle of Willis is given.
Brief description of an aneurysm as an abnormal irreversible dilatation of vessel wall, which can often rupture spontaneously without any warning, is given. Worth mentioning that 80% of cases of SAH are due to spontaneous rupture of a Berry Aneurysm anywhere in Circle of Willis.
Remaining 20% can be due to spontaneous rupture of an Arteriovenous malformation (AV malformation).
A brief comparison of arterial sources of 4 types of hemorrhages is given; Epidural Hemorrhage (EH) = Middle Meningeal Artery. Subdural Hemorrhage (SH) = Cerebral Veins/Bridging Veins. Sub Arachnoid Hemorrhage = Aneurysm and AV malformation in any of major cerebral arteries.
Clinically a person suffering from a SAH will present with "very very severe headache" or "the worst headache of my life", a severe excruciating headache that is not preceded by any sort of trauma.
While a person with SH would have history of a fall few hours ago, along with fluctuations in level of consciousness.
Lumbar Puncture (performed only after confirmation of absence of raised Intracerebral Pressure [ICP]) will show RBCs mixed with CSF.
Summary of Epidural, Subdural, Sub Arachnoid and Intracerebral types of hemorrhages.
A further mention of Intracerebral Hemorrhage (ICH), its causes and presentation; Chronic hypertension leads to development of micro aneurysms whose rupture causes an Intracerebral Hemorrhage (ICH). As for clinical presentation, a person who just suffered an ICH would have some sort of associated neurological deficit like Hemiparesis, Dysarthria, etc.
A summary of the comparison of clinical presentations is provided.
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