Intracranial Bleeds

Sub-Arachnoid Hemorrhage    Aneurysms occur most frequently at the bifurcations of the basal cerebral arteries, implying a hemodynamic effect to the vessel wall. Almost all of the SAH is due to ruptured berry aneurysms. Other important causes include trauma, cocaine abuse, AV malformations and vasculitis. HTN, smoking and HLP are strongly associated with development of aneurysms.    Cause … Read more

Acute Stroke

Definition  Stroke is defined as sudden onset of a neurologic deficit from a vascular mechanism. 85% of strokes are ischemic  and 15% are primary hemorrhages (Subarachnoid and Intraparenchymal).  Transient ischemic attacks (TIAs) are episodes of stroke symptoms that resolve rapidly, lasting fewer than 24 hours.   However, infarcts of the brain do occur in 15–50% of TIAs even though neurologic signs and … Read more


Meningitis:  The meninges consist of three parts: the pia, arachnoid, and dura maters. Bacterial meningitis reflects infection of the arachnoid mater and the CSF in both the subarachnoid space and the cerebral ventricles.     Etiology:  Streptococcus pneumoniae, Neisseria meningitidis, and, less often, Haemophilus influenzae and group B streptococcus are the most likely causes of community-acquired bacterial meningitis … Read more


                         Encephalitis:    Encephalitis is defined by the presence of an inflammatory process of the brain in association with clinical evidence of neurologic dysfunction.    It is important to distinguish between infectious encephalitis and post infectious or post immunization encephalitis or encephalomyelitis (e.g., acute disseminated encephalomyelitis [ADEM]), which may be mediated by an immunologic response to an antecedent antigenic stimulus from an infecting … Read more


Approach to Seizures    Definition  A seizure is a paroxysmal event due to abnormal, excessive, hypersynchronous discharges from an aggregate of central nervous system (CNS) neurons.  Epilepsy describes a condition in which a person has recurrent seizures due to a chronic, underlying process. i.e. 2 or more episodes of seizures.  Partial (or focal) seizures  Simple-partial seizures … Read more