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Subarachnoid Hemorrhage
Subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space—the area between the arachnoid membrane and the pia mater surrounding the brain. Symptoms may include a severe headache of rapid onset, vomiting, decreased level of consciousness, fever, and sometimes seizures. Neck stiffness or neck pain are also relatively common. In about a quarter of people a small bleed with resolving symptoms occurs within a month of a larger bleed. SAH may occur as a result of a head injury or spontaneously, usually from a ruptured cerebral aneurysm. Risk factors for spontaneous cases include high blood pressure, smoking, family history, alcoholism, and cocaine use. Generally, the diagnosis can be determined by a CT scan of the head if done within six hours of symptom onset. Occasionally, a lumbar puncture is also required. After confirmation further tests are usually performed to determine the underlying cause. Treatment is by prompt neurosurgery or endovascular coiling. Me ...
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Sulcus (neuroanatomy)
In neuroanatomy, a sulcus (Latin: "furrow", pl. ''sulci'') is a depression or groove in the cerebral cortex. It surrounds a gyrus (pl. gyri), creating the characteristic folded appearance of the brain in humans and other mammals. The larger sulci are usually called fissures. Structure Sulci, the grooves, and gyri, the folds or ridges, make up the folded surface of the cerebral cortex. Larger or deeper sulci are termed fissures, and in many cases the two terms are interchangeable. The folded cortex creates a larger surface area for the brain in humans and other mammals. When looking at the human brain, two-thirds of the surface are hidden in the grooves. The sulci and fissures are both grooves in the cortex, but they are differentiated by size. A sulcus is a shallower groove that surrounds a gyrus. A fissure is a large furrow that divides the brain into lobes and also into the two hemispheres as the longitudinal fissure. Importance of expanded surface area As the sur ...
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Meningitis
Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or altered consciousness, nausea, vomiting, and an inability to tolerate light or loud noises. Young children often exhibit only nonspecific symptoms, such as irritability, drowsiness, or poor feeding. A non-blanching rash (a rash that does not fade when a glass is rolled over it) may also be present. The inflammation may be caused by infection with viruses, bacteria or other microorganisms. Non-infectious causes include malignancy (cancer), subarachnoid haemorrhage, chronic inflammatory disease (sarcoidosis) and certain drugs. Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore, the condition is classified as a medical emergency. A lumbar puncture, in which a needle is ins ...
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Head Injury
A head injury is any injury that results in trauma to the skull or brain. The terms ''traumatic brain injury'' and ''head injury'' are often used interchangeably in the medical literature. Because head injuries cover such a broad scope of injuries, there are many causes—including accidents, falls, physical assault, or traffic accidents—that can cause head injuries. The number of new cases is 1.7 million in the United States each year, with about 3% of these incidents leading to death. Adults have head injuries more frequently than any age group resulting from falls, motor vehicle crashes, colliding or being struck by an object, or assaults. Children, however, may experience head injuries from accidental falls or intentional causes (such as being struck or shaken) leading to hospitalization. Acquired brain injury (ABI) is a term used to differentiate brain injuries occurring after birth from injury, from a genetic disorder, or from a congenital disorder. Unlike a broken bo ...
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Fever
Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using values between in humans. The increase in set point triggers increased muscle contractions and causes a feeling of cold or chills. This results in greater heat production and efforts to conserve heat. When the set point temperature returns to normal, a person feels hot, becomes flushed, and may begin to sweat. Rarely a fever may trigger a febrile seizure, with this being more common in young children. Fevers do not typically go higher than . A fever can be caused by many medical conditions ranging from non-serious to life-threatening. This includes viral, bacterial, and parasitic infections—such as influenza, the common cold, meningitis, urinary tract infections, appendicitis, Lassa, COVID-19, and malaria. Non-infectious cau ...
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Thunderclap Headache
A thunderclap headache is a headache that is severe and has a sudden onset. It is defined as a severe headache that takes seconds to minutes to reach maximum intensity. Although approximately 75% are attributed to "primary" headaches—headache disorder, non-specific headache, idiopathic thunderclap headache, or uncertain headache disorder—the remainder are secondary to other causes, which can include some extremely dangerous acute conditions, as well as infections and other conditions. Usually, further investigations are performed to identify the underlying cause. Signs and symptoms A headache is called "thunderclap headache" if it is severe in character and reaches maximum severity within seconds to minutes of onset. In many cases, there are no other abnormalities, but the various causes of thunderclap headaches may lead to a number of neurological symptoms. Causes Approximately 75% are attributed to "primary" headaches: headache disorder, non-specific headache, idiopathic th ...
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Human Brain
The human brain is the central organ (anatomy), organ of the human nervous system, and with the spinal cord makes up the central nervous system. The brain consists of the cerebrum, the brainstem and the cerebellum. It controls most of the activities of the human body, body, processing, integrating, and coordinating the information it receives from the Sensory nervous system, sense organs, and making decisions as to the instructions sent to the rest of the body. The brain is contained in, and protected by, the neurocranium, skull bones of the human head, head. The cerebrum, the largest part of the human brain, consists of two cerebral hemispheres. Each hemisphere has an inner core composed of white matter, and an outer surface – the cerebral cortex – composed of grey matter. The cortex has an outer layer, the neocortex, and an inner allocortex. The neocortex is made up of six Cerebral cortex#Layers of neocortex, neuronal layers, while the allocortex has three or four. Each ...
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Pia Mater
Pia mater ( or ),Entry "pia mater"
in
Merriam-Webster Online Dictionary
', retrieved 2012-07-28.
often referred to as simply the pia, is the delicate innermost layer of the , the membranes surrounding the and . ''Pia mater'' is medieval Latin meaning "tender mother". The other two meningeal membr ...
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Arachnoid (brain)
The arachnoid mater (or simply arachnoid) is one of the three meninges, the protective membranes that cover the brain and spinal cord. It is so named because of its resemblance to a spider web. The arachnoid mater is a derivative of the neural crest mesoectoderm in the embryo. Structure It is interposed between the two other meninges, the more superficial and much thicker dura mater and the deeper pia mater, from which it is separated by the subarachnoid space. The delicate arachnoid layer is not attached to the inside of the dura but against it and surrounds the brain and spinal cord. It does not line the brain down into its sulci (folds), as does the pia mater, with the exception of the longitudinal fissure, which divides the left and right cerebral hemispheres. Cerebrospinal fluid (CSF) flows under the arachnoid in the subarachnoid space, within a meshwork of trabeculae which span between the arachnoid and the pia. The arachnoid mater makes arachnoid villi, small protrusions ...
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Subarachnoid Space
In anatomy, the meninges (, ''singular:'' meninx ( or ), ) are the three membranes that envelop the brain and spinal cord. In mammals, the meninges are the dura mater, the arachnoid mater, and the pia mater. Cerebrospinal fluid is located in the subarachnoid space between the arachnoid mater and the pia mater. The primary function of the meninges is to protect the central nervous system. Structure Dura mater The dura mater ( la, tough mother) (also rarely called ''meninx fibrosa'' or ''pachymeninx'') is a thick, durable membrane, closest to the skull and vertebrae. The dura mater, the outermost part, is a loosely arranged, fibroelastic layer of cells, characterized by multiple interdigitating cell processes, no extracellular collagen, and significant extracellular spaces. The middle region is a mostly fibrous portion. It consists of two layers: the endosteal layer, which lies closest to the skull, and the inner meningeal layer, which lies closer to the brain. It contains ...
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Bleeding
Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vagina or anus, or through a puncture in the skin. Hypovolemia is a massive decrease in blood volume, and death by excessive loss of blood is referred to as exsanguination. Typically, a healthy person can endure a loss of 10–15% of the total blood volume without serious medical difficulties (by comparison, blood donation typically takes 8–10% of the donor's blood volume). The stopping or controlling of bleeding is called hemostasis and is an important part of both first aid and surgery. Types * Upper head ** Intracranial hemorrhage – bleeding in the skull. ** Cerebral hemorrhage – a type of intracranial hemorrhage, bleeding within the brain tissue itself. ** Intracerebral hemorrhage – bleeding in the brain caused by the rupture of ...
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Nimodipine
Nimodipine, sold under the brand name Nimotop among others, is calcium channel blocker used in preventing vasospasm secondary to subarachnoid hemorrhage (a form of cerebral hemorrhage). It was originally developed within the calcium channel blocker class as it was used for the treatment of high blood pressure, but is not used for this indication. It was patented in 1971 and approved for medical use in the US in 1988. It was approved for medical use in Germany in 1985. Medical use Because it has some selectivity for cerebral vasculature, nimodipine's main use is in the prevention of cerebral vasospasm and resultant ischemia, a complication of subarachnoid hemorrhage (a form of cerebral bleed), specifically from ruptured intracranial berry aneurysms irrespective of the patient's post-ictus neurological condition. Its administration begins within 4 days of a subarachnoid hemorrhage and is continued for three weeks. If blood pressure drops by over 5%, dosage is adjusted ...
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Labetalol
Labetalol is a medication used to treat high blood pressure and in long term management of angina. This includes essential hypertension, hypertensive emergencies, and hypertension of pregnancy. In essential hypertension it is generally less preferred than a number of other blood pressure medications. It can be given by mouth or by injection into a vein. Common side effects include low blood pressure with standing, dizziness, feeling tired, and nausea. Serious side effects may include low blood pressure, liver problems, heart failure, and bronchospasm. Use appears safe in the latter part of pregnancy and it is not expected to cause problems during breastfeeding. It works by blocking the activation of β-receptors and α-receptors. Labetalol was patented in 1966 and came into medical use in 1977. It is available as a generic medication. In 2020, it was the 210th most commonly prescribed medication in the United States, with more than 2million prescriptions. Medical uses La ...
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