Management of Increased Intracranial Pressure
Brain tissue, cerebrospinal fluid (CSF), and blood are contained within the confined space of the skull. An increase in volume of one of these components necessarily results in a compensatory…
Brain Death
A. Brain death is defined, in the United States and many other countries, as permanent and irreversible cessation of whole brain function. Some countries, such as the United Kingdom, consider…
Cerebral Venous Sinus Thrombosis
Cerebral venous sinus thrombosis (CVST) presents with progressive headache, papilledema, changes in mental status, focal neurologic deficits, and/or seizures. Obstructed venous drainage causes venous congestion, resulting in cerebral edema, hemorrhage,…
Vascular Malformations
Vascular malformations of the brain can be organized into five subtypes: (1) cavernous malformations, (2) capillary telangiectasias, (3) arteriovenous malformations (AVMs), (4) developmental venous anomalies, and (5) dural arteriovenous fistulas…
Unruptured Intracranial Aneurysm
Management of unruptured intracranial aneurysms (UIAs) poses a conundrum to physicians. The prevalence of UIAs is approximately 3%, the majority of which are discovered incidentally. Rupture of an aneurysm can…
Subarachnoid Hemorrhage
Subarachnoid hemorrhage (SAH) refers to bleeding within the cerebrospinal fluid (CSF)-filled subarachnoid space. The majority of spontaneous cases are due to ruptured cerebral aneurysms, but 15%–20% are due to another…
Restarting Antithrombotic Therapy After Intracerebral Hemorrhage
Patients with intracerebral hemorrhage often have concurrent ischemic vascular disease, venous thromboembolic disease, or atrial fibrillation for which antiplatelet (AP) or anticoagulant (AC) therapy would be indicated. Deciding if and…
Intracerebral Hemorrhage Due to Anticoagulant Therapy
Patients taking anticoagulants have larger baseline intracerebral hemorrhage volume, greater early hemorrhage expansion, and increased morbidity and mortality compared to those not on anticoagulants. While there is little formal data…
Intracerebral Hemorrhage in the Young
Intracerebral hemorrhage (ICH) is uncommon in young adults (age < 50 years) but is more likely to be associated with specific underlying vascular abnormalities than in older patients. Given this,…
Acute Spontaneous Intracerebral Hemorrhage
A. Patients with intracerebral hemorrhage (ICH) have a high risk of neurologic deterioration, particularly early after presentation. Close neurologic monitoring is thus important. Intubation and mechanical ventilation are necessary in…
