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Pathology - Subarachnoid Bleeding
Pathophysiology
In this instance, the bleeding is most likely the result of a berry aneurysm rupturing. Because of the uneven collagen deposition in the vasculature, berry aneurysms are frequently connected with Marfan's syndrome, which the patient's height implies may be the cause of. The symptoms of ipsilateral oculomotor nerve palsy, also known as cranial nerve III palsy, include an extorted, laterally turned eye with a dilated pupil. Berry aneurysms of the posterior connecting artery can induce this condition. Compression of the nearby oculomotor nerve is the cause of this. In addition to frank blood on lumbar puncture, patients with subarachnoid hemorrhage may also have xanthochromia, or yellow staining of CSF, as a result of RBC breakdown. Subarachnoid blood irritates the meninges, causing nuchal stiffness. In addition to nimodipine, a dihydropyridine calcium channel blocker that prevents reactive vasospasm and consequent ischemia to the tissue fed by the afflicted arterial, surgically cutting the aneurysm is the method of treatment.
Pathophysiology
In this instance, the bleeding is most likely the result of a berry aneurysm rupturing. Because of the uneven collagen deposition in the vasculature, berry aneurysms are frequently connected with Marfan's syndrome, which the patient's height implies may be the cause of. The symptoms of ipsilateral oculomotor nerve palsy, also known as cranial nerve III palsy, include an extorted, laterally turned eye with a dilated pupil. Berry aneurysms of the posterior connecting artery can induce this condition. Compression of the nearby oculomotor nerve is the cause of this. In addition to frank blood on lumbar puncture, patients with subarachnoid hemorrhage may also have xanthochromia, or yellow staining of CSF, as a result of RBC breakdown. Subarachnoid blood irritates the meninges, causing nuchal stiffness. In addition to nimodipine, a dihydropyridine calcium channel blocker that prevents reactive vasospasm and consequent ischemia to the tissue fed by the afflicted arterial, surgically cutting the aneurysm is the method of treatment.
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