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Medicine C.N.S. 3741fd00

Which of the following is the most common location of hypertensive hemorrhage?

A
Pons
B
Putamen
C
Thalamus
D
Subcortical white matter
High-Yield Explanation
i.e. (Putamen): (948-CMDT-11)The putamen is the most common site of hypertensive haemorrhageExternal capsule refers to a thin layer of white matter that seperates the lateral part oflentiform nucleus (putamen) from claustrum and is invariably damaged along with the putamen* Hypertensive intracerebral hemorrhage occurs most frequently in the basal ganglia and less commonly in the pons, thalamus, cerebellum and cerebral white matter* Most common cause of "Sub arachnoid haemorrhage" is spontaneous rupture of saccular aneurysm*** Most common cause of intracerebral haemorrhage" is hypertension due to rupture of small perforating arteries or Arterioles* Most common cause of intraparenchymal haemorrhage is Hypertension* Most common artery involved in intraparenchymal haemorrhage is Lentiulostriate arteries**Clinical featuresHypertensive hemorrhageSubarachnoid hemorrhage* Hemorrhage generally presents as abrupt onset of focal neurological deficit* Focal neurological deficit gradually worsens and is accompanied by signs of increased intracranial pressure (ICP) such as headache and vomiting* In hypertensive bleeding the hemorrhage is intracerebral not in subarachnoid space1. Sudden headache in the absence of focal neurological deficit is the hall mark of aneurysmal rupture**2. The patient often calls the headache the worst headache of his life3. Brief period of unconsciousness4. Nuchal rigidity and other signs of meningeal irritationThe hall mark of aneurysmal rupture is blood in the C.S.F** (blood in sylvian fissure indicates blood in sub arachnoid space filled with C.S.F)

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