Intracerebral hemorrhage physical examination: Difference between revisions
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Physical examination of patients with Intracerebral hemorrhage is usually varies based on the location of the bleeding. | Physical examination of patients with Intracerebral hemorrhage is usually varies based on the location of the bleeding. | ||
Putamenal hemorrhage: | |||
Commonly occurs along white matter fiber tracts | |||
Cerebellar hemorrhages: | |||
Usually occurs in the dentate nucleus, extend into the hemisphere and fourth ventricle, and possibly into the pontine tegmentum. | |||
35 percent of cases, subcortex in 30 percent, cerebellum in 16 percent, thalamus in 15 percent, and pons in 5 to 12 percent | 35 percent of cases, subcortex in 30 percent, cerebellum in 16 percent, thalamus in 15 percent, and pons in 5 to 12 percent | ||
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! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Physical examination}} | ! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Physical examination}} | ||
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| style="padding: 5px 5px; background: #DCDCDC;" | '''Putamenal hemorrhage''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''Putamenal hemorrhage''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*[[Hemiplegia]] | *[[Hemiplegia]] | ||
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*[[Coma]] | *[[Coma]] | ||
|- | |- | ||
| rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" | '''Thalamic hemorrhage''' | | rowspan="2" style="padding: 5px 5px; background: #DCDCDC;" | '''Thalamic hemorrhage''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" |General signs: | | style="padding: 5px 5px; background: #F5F5F5;" |General signs: | ||
* | *Downward gaze (paralysis of upward gaze) | ||
*Small pupils (lack of light pupillary response) | *Small pupils (lack of light pupillary response) | ||
*Depressed consciousness | *Depressed consciousness | ||
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*Posterior: No specific behavioural pattern however can include [[cognitive dysfunction]], [[neglect]], [[aphasia]] | *Posterior: No specific behavioural pattern however can include [[cognitive dysfunction]], [[neglect]], [[aphasia]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''Pontine hemorrhage''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''Pontine hemorrhage''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Decreased level of consciousness (most common) | *Decreased level of consciousness (most common) | ||
*Long tract signs including | *Long tract signs including [[tetraparesis]] | ||
*Cranial nerve palsies | *[[Cranial nerve palsies]] | ||
*[[Seizures]] | *[[Seizures]] | ||
*Cheyne-Stokes respiration | *[[Cheyne-Stokes respiration]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''Cerebellar hemorrhage''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''Cerebellar hemorrhage''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Small bleeds | *Small bleeds | ||
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|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" |''' Lobar hemorrhage | | style="padding: 5px 5px; background: #DCDCDC;" |''' Lobar hemorrhage | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" |The signs vary depending on the location of the hemorrhage: | ||
*Acute neurological deterioration | *Acute neurological deterioration | ||
*Decreased GCS | *Decreased GCS | ||
*[[Seizure]] | |||
*Contralateral [[homonymous hemianopsia]] (occipital hemorrhage) | |||
*Contralateral plegia/[[paresis]] of the leg with relative sparing of the arm (frontal hemorrhage) | |||
|} | |} | ||
Revision as of 18:53, 29 November 2016
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Intracerebral hemorrhage Microchapters |
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Diagnosis |
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Treatment |
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AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage (2015) |
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AHA/ASA Guideline Recommendation for the Primary Prevention of Stroke (2014) |
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Case Studies |
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Intracerebral hemorrhage physical examination On the Web |
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American Roentgen Ray Society Images of Intracerebral hemorrhage physical examination |
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Risk calculators and risk factors for Intracerebral hemorrhage physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Physical examination
Physical examination
Physical examination of patients with Intracerebral hemorrhage is usually varies based on the location of the bleeding.
Putamenal hemorrhage:
Commonly occurs along white matter fiber tracts
Cerebellar hemorrhages:
Usually occurs in the dentate nucleus, extend into the hemisphere and fourth ventricle, and possibly into the pontine tegmentum.
35 percent of cases, subcortex in 30 percent, cerebellum in 16 percent, thalamus in 15 percent, and pons in 5 to 12 percent
| Locations | Physical examination |
|---|---|
| Putamenal hemorrhage | |
| Thalamic hemorrhage | General signs:
|
Behavioural patterns based on the four main arterial thalamic territories:
| |
| Pontine hemorrhage |
|
| Cerebellar hemorrhage |
|
| Lobar hemorrhage | The signs vary depending on the location of the hemorrhage:
|