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Questions How is hemorrhagic stroke different from ischemic stroke? What is the greatest risk factor associated with a stroke? What threat does blood from an ICH pose on the brain? What is Cushing’s triad? What surgical interventions are available to evacuate an ICH? How is ICP monitored and recorded? How is CPP calculated? Explain the difference between craniotomy and craniectomy. What are possible complications associated with a decompressive craniectomy?

Answer 1

Hemorrhagic stroke occurs when the artery begins to bleed into the brain this is due to weak blood vessels that burst and bleed into the surrounding area, it damages the brain cells due to the pressure, so there will be impaired function in the damaged area. An ischemic stroke happens when blood vessels supply become booked in the area of the brain due to blood clots, plugs, stenosis, or narrowing of the artery. this interrupts the blood supply to the brain that causes brain cells to die.
Risk factors for stroke include diabetes, high blood pressure, high HDL level, heart, and blood vessel abnormalities and diseases, smoking, infection, inflammation, age factors, brain aneurysm, etc.
When the low serum concentration that cause decreases plasma osmolality and increases the intracellular fluid and interstitial fluids. it causes systemic hypotension that increases the brain water content that causes swelling of the brain. hyponatremia potentially harmful to the brain.
Cushing's triad indicates the presence of hypertension that elevate the intracranial pressure that widens the pulse pressure, tachycardia, and irregular respiratory cycles changes its regulatory. it is a change in body experience to compensate for rising ICP. it is hypertension, bradycardia, and irregular respirations.
surgical management for ICH is surgical decompression of the skull and evaluation of expanding hematoma, craniotomy, and craniectomy.
Intracranial pressure(ICP) monitoring is a diagnostic test using device place inside the head.it senses the pressure inside the skull and that helps doctors to determine high or low CSF pressure that causing any symptoms. using small pressure-sensitive probe inserted through the skull and connected to the ICP recording system ICP will be measured continuously.
CPP is cerebral perfusion pressure calculated as MAP. MAP is the average blood pressure during one cardiac cycle. calculating CPP through MAP-ICP. it is useful guiding the management of the patient with traumatic brain injury.
A craniotomy is the surgical removal of the part of the bone from skull to expose the brain. craniectomy is also surgical removal of the part of the skull to relieve the pressure in that area where the brain swells. both craniotomy and craniectomy are the same but the difference is after craniotomy the bone is replaced, after craniectomy the bone is not immediately replaced.
complications associated with decompressive craniectomy is cerebral contusion expansion, subdural hematoma, epilepsy, CSF leakage through the scalp, external cerebral herniation.