Changes on ct scan in haemorrhagic stroke
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Changes on CT Scan in Haemorrhagic Stroke. Musarrat Ansari. Haemorrhagic Stroke. 2 main types: Intracerebral haemorrhage - Occurs due to rupture of micro-aneurysms on branches of eg middle cerebral arteries. Subarachnoid haemorrhage

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Haemorrhagic stroke l.jpg
Haemorrhagic Stroke

2 main types:

  • Intracerebral haemorrhage

    - Occurs due to rupture of micro-aneurysms on branches of eg middle cerebral arteries.

  • Subarachnoid haemorrhage

    - Rupture of berry aneurysms into the subarachnoid space.


Intracerebral haemorrhage ich l.jpg
Intracerebral Haemorrhage (ICH)

Most common locations of spontaneous ICH are:

  • Lobar (40 – 50%)

  • Putamen (40%)

  • Cerebellum (5 – 10%)

  • Thalamus (5%)

  • Pons (5%)


Intracerebral haemorrhage l.jpg
Intracerebral Haemorrhage

  • Haematomas increase in size 1-2 hours after onset and may continue to increase for 12 hours or longer.

  • Deeply placed haematomas are characteristic of hypertension.

  • Most episodes of bleeding start at times of the day when arterial pressures are higher.

  • Bleeding is often initiated at the junction of gray and white matter.



Subarachnoid haemorrhage sah l.jpg
Subarachnoid Haemorrhage (SAH)

  • sensitivity of head CT for subarachnoid hemorrhage varies with time course:

  • acutely 95-100%

  • after 5 days 85%

  • after 7 days 50%


Delayed cerebral ischaemia after sah l.jpg
Delayed Cerebral Ischaemia After SAH

  • Peak frequency from day 5 to day 14.

  • Occurrence strongly related to the total amount of subarachnoid blood – occurs only if source is a ruptured aneurysm.

  • Loss of consciousness at time of haemorrhage is an important predictive factor for delayed cerebral ischaemia.



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