[MCQ] Intracranial hemorrhage- Part 1

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Intracranial hemorrhage- Part 1

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Question 1

In intraparenchymal hemorrhage, mean arterial blood pressure should be ?

A	< 160 mm Hg
B	< 150 mm Hg
C	< 140 mm Hg
D	< 130 mm Hg

Question 2

Which of the following drugs is useful in lowering blood pressure in intraparenchymal hemorrhage ?

A	Nicardipine
B	Labetalol
C	Esmolol
D	All of the above

Question 2 Explanation:

Intraparenchymal hemorrhage is exacerbated by acutely elevated BP & should be lowered to a mean arterial BP of <130 mm Hg by nonvasodilating IV drugs (nicardipine, labetalol or esmolol).

Question 3

Out of the following hemorrhagic stroke subtypes, which has the maximum frequency of occurrence ?

A	Intraparenchymal
B	Subdural
C	Epidural
D	Subarachnoid

Question 3 Explanation:

Intraparenchymal hemorrhage is the most common type of intracranial hemorrhage. It accounts for ~10% of all strokes and is associated with a 50% case fatality rate. Hypertension, trauma and cerebral amyloid angiopathy cause the majority of intraparenchymal hemorrhage

Question 4

Which of the following is the most important causes of intraparenchymal hemorrhage in the young ?

A	Hypertension
B	Cerebral amyloid angiopathy
C	Cocaine use
D	Heavy alcohol consumption

Question 4 Explanation:

Advanced age and heavy alcohol consumption increase the risk of intraparenchymal hemorrhage. Cocaine use is one of the most important causes in young (<45 years). Intracerebral hemorrhage, ischemic stroke, and SAH are all associated with cocaine use.

Question 5

Hypertensive intraparenchymal hemorrhage is due to spontaneous rupture of ?

A	Penetrating artery
B	Bifurcation of artery
C	Aneurysm of artery
D	Any of the above

Question 5 Explanation:

Hypertensive intraparenchymal hemorrhage usually results from spontaneous rupture of a small penetrating artery deep in the brain.

Question 6

Which of the following is not a common site for hypertensive intraparenchymal hemorrhage ?

A	Basal ganglia
B	Cerebellum
C	Pons
D	Medulla oblongata

Question 6 Explanation:

The most common sites of hypertensive intraparenchymal hemorrhage are basal ganglia (esp. putamen), thalamus, cerebellum and pons.

Question 7

Out of the following, which is the most common site for hypertensive intraparenchymal hemorrhage ?

A	Thalamus
B	Putamen
C	Caudate nucleus
D	Globus pallidus

Question 7 Explanation:

Putamen is the most common site for hypertensive intraparenchymal hemorrhage

Question 8

In hypertensive intraparenchymal hemorrhage, if blood dissects into the ventricular space, the morbidity ?

A	Remains the same
B	Increases
C	Decreases
D	Any of the above

Question 8 Explanation:

In hypertensive intraparenchymal hemorrhage, blood may dissect into the ventricular space which substantially ‘increases’ morbidity and may cause hydrocephalus.

Question 9

Most hypertensive intraparenchymal hemorrhages develop over what period of time ?

A	1 to 10 minutes
B	10 to 30 minutes
C	30 to 90 minutes
D	90 to 180 minutes

Question 9 Explanation:

Most hypertensive intraparenchymal hemorrhages develop over 30 to 90 minutes.

Question 10

Which of the following statements about intracerebral hemorrhages is false ?

A	Almost always occur in awake state
B	Abrupt onset of focal neurologic deficit
C	Seizures are common
D	Focal deficit worsens steadily over 30 to 90 minutes

Question 10 Explanation:

Intracerebral hemorrhages almost always occur in awake state. Hemorrhage presents as abrupt onset of focal neurologic deficit. Seizures are uncommon. Focal deficit worsens steadily over 30- 90 minutes with a diminishing level of consciousness & signs of raised ICP (headache/vomiting).

Question 11

In hypertensive putaminal hemorrhage, the eyes deviate towards which side ?

A	Away from the side of hemiparesis
B	Towards the side of hemiparesis
C	Remain in the center
D	Rotate upwards

Question 11 Explanation:

In putaminal hypertensive hemorrhage, contralateral hemiparesis is the sentinel sign. Eyes deviate away from the side of hemiparesis.

Question 12

In hypertensive intraparenchymal hemorrhage, if there is a downward & inward deviation of eyes, the location of hemorrhage is in ?

A	Putamen
B	Thalamus
C	Pons
D	Cerebellum

Question 12 Explanation:

Thalamic hemorrhages may extend inferiorly into upper midbrain and cause deviation of eyes downward and inward.

Question 13

In thalamic hemorrhage, which of the following sensory modality is affected ?

A	Exteroceptive
B	Proprioceptive
C	Cortical
D	All of the above

Question 13 Explanation:

Thalamic hemorrhages also produce contralateral hemiplegiadue to involvement of adjacent internal capsule. Prominent sensory deficit involving all modalities is usually present.

Question 14

Which of the following is true in thalamic hemorrhage ?

A	Unequal pupils with absence of light reaction
B	Absence of convergence
C	Ipsilateral Horner’s syndrome
D	All of the above

Question 14 Explanation:

Thalamic hemorrhages by extension inferiorly into upper midbrain may lead to homonymous visual field defect, unequal pupils with absence of light reaction, skew deviation with eye opposite hemorrhage displaced downward & medially, ipsilateral Horner’s syndrome, absence of convergence, paralysis of vertical gaze, and retraction nystagmus.

Question 15

In hypertensive intraparenchymal hemorrhage, if there is impairment of doll’s head or oculocephalic maneuver, the location of hemorrhage is in ?

A	Putamen
B	Thalamus
C	Pons
D	Cerebellum

Question 15 Explanation:

In pontine hemorrhages, there is impairment of reflex horizontal eye movements evoked by head turning (doll’s head or oculocephalic maneuver).

Question 16

Excessive sweating (hyperhidrosis) is a feature of which of the following CVA’s ?

A	Basal ganglia hemorrhage
B	Thalamic hemorrhage
C	Pontine hemorrhage
D	Cerebellar hemorrhage

Question 16 Explanation:

Presentation of pontine hemorrhage include sudden onset, pinpoint pupils (1 mm) reactive to light, loss of reflex eye movements and corneal responses, ocular bobbing, posturing, hyperventilation, severe hypertension and excessive sweating

Question 17

Decerebrate rigidity is most frequent which of the following hypertensive intraparenchymal hemorrhage ?

A	Basal ganglia hemorrhage
B	Thalamic hemorrhage
C	Pontine hemorrhage
D	Cerebellar hemorrhage

Question 17 Explanation:

In pontine hemorrhages, deep coma with quadriplegia usually occurs over a few minutes with prominent decerebrate rigidity.

Question 18

Cerebellar hemorrhages are characterized by ?

A	Occipital headache
B	Repeated vomiting
C	Ataxia of gait
D	All of the above

Question 18 Explanation:

Cerebellar hemorrhages develop over several hours & are characterized by occipital headache, repeated vomiting, and ataxia of gait.

Question 19

In mild cases of cerebellar hemorrhage, there may be no other neurologic signs other than ?

A	Gait ataxia
B	Occipital headache
C	Repeated vomiting
D	Seizure

Question 19 Explanation:

In mild cases of cerebellar hemorrhage, there may be no other neurologic signs other than gait ataxia.

Question 20

Which of the following about cerebellar hemorrhage is false ?

A	Forced deviation of eyes to opposite side
B	Paresis of conjugate lateral gaze toward side of hemorrhage
C	Usually develop over several hours
D	None of the above

Question 20 Explanation:

In cerebellar hemorrhage, dizziness or vertigo may be prominent. There is paresis of conjugate lateral gaze toward the side of hemorrhage, forced deviation of eyes to opposite side, or an ipsilateral sixth nerve palsy.

Question 21

Which of the following lobar hemorrhage causes arm weakness ?

A	Occipital hemorrhage
B	Left temporal hemorrhage
C	Parietal hemorrhage
D	Frontal hemorrhage

Question 21 Explanation:

Major neurologic deficit with occipital hemorrhage is hemianopia, with left temporal hemorrhage it is aphasia and delirium, with parietal hemorrhage it is hemisensory loss and with frontal hemorrhage it is arm weakness.

Question 22

Which of the following is uncommon in lobar hemorrhages ?

A	Focal headaches
B	Vomiting
C	Drowsiness
D	Stiff neck

Question 22 Explanation:

Most patients with lobar hemorrhages have focal headaches and more than half vomit or are drowsy. Stiff neck and seizures are uncommon.

Question 23

Which of the following is mainly affected in cerebral amyloid angiopathy ?

A	Arterioles
B	Venules
C	Capillaries
D	All of the above

Question 24

Cerebral amyloid angiopathy affects mainly ?

A	Children
B	Adults
C	Elderly
D	All of the above

Question 24 Explanation:

Cerebral amyloid angiopathy is a disease of the elderly in which arteriolar degeneration occurs and amyloid is deposited in the walls of the cerebral arteries.

Question 25

Cerebral amyloid angiopathy cause which of the following ?

A	Intraparenchymal hemorrhage
B	Lobar hemorrhage
C	Cerebellar hemorrhage
D	Subarachnoid hemorrhage

Question 25 Explanation:

Cerebral amyloid angiopathy causes both single and recurrent lobar hemorrhages and is the most common cause of lobar hemorrhage in elderly.

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See all quizzes of Intracranial hemorrhage at here:

Intracranial hemorrhage- Part 1|Intracranial hemorrhage- Part 2

1 In intraparenchymal hemorrhage, mean arterial blood pressure
should be ?
A. < 160 mm Hg
B. < 150 mm Hg
C. < 140 mm Hg
D. < 130 mm Hg
2 Which of the following drugs is useful in lowering blood pressure
in intraparenchymal hemorrhage ?
A. Nicardipine
B. Labetalol
C. Esmolol
D. All of the above

3 Out of the following hemorrhagic stroke subtypes, which has the
maximum frequency of occurrence ?
A. Intraparenchymal
B. Subdural
C. Epidural
D. Subarachnoid

4 Which of the following is the most important causes of
intraparenchymal hemorrhage in the young ?
A. Hypertension
B. Cerebral amyloid angiopathy
C. Cocaine use
D. Heavy alcohol consumption

5 Hypertensive intraparenchymal hemorrhage is due to spontaneous
rupture of ?
A. Penetrating artery
B. Bifurcation of artery
C. Aneurysm of artery
D. Any of the above

6 Which of the following is not a common site for hypertensive
intraparenchymal hemorrhage ?
A. Basal ganglia
B. Cerebellum
C. Pons
D. Medulla oblongata

8 Out of the following, which is the most common site for
hypertensive intraparenchymal hemorrhage ?
A. Thalamus
B. Putamen
C. Caudate nucleus
D. Globus pallidus

9 In hypertensive intraparenchymal hemorrhage, if blood dissects
into the ventricular space, the morbidity ?
A. Remains the same
B. Increases
C. Decreases
D. Any of the above

10 Most hypertensive intraparenchymal hemorrhages develop over
what period of time ?
A. 1 to 10 minutes
B. 10 to 30 minutes
C. 30 to 90 minutes
D. 90 to 180 minutes

11 Which of the following statements about intracerebral hemorrhages
is false ?
A. Almost always occur in awake state
B. Abrupt onset of focal neurologic deficit
C. Seizures are common
D. Focal deficit worsens steadily over 30 to 90 minutes

12 In hypertensive putaminal hemorrhage, the eyes deviate towards
which side ?
A. Away from the side of hemiparesis
B. Towards the side of hemiparesis
C. Remain in the center
D. Rotate upwards

13 In hypertensive intraparenchymal hemorrhage, if there is a
downward & inward deviation of eyes, the location of hemorrhage
is in ?
A. Putamen
B. Thalamus
C. Pons
D. Cerebellum

14 In thalamic hemorrhage, which of the following sensory modality
is affected ?
A. Exteroceptive
B. Proprioceptive
C. Cortical
D. All of the above

15 Which of the following is true in thalamic hemorrhage ?
A. Unequal pupils with absence of light reaction
B. Absence of convergence
C. Ipsilateral Horner’s syndrome
D. All of the above

16 In hypertensive intraparenchymal hemorrhage, if there is
impairment of doll’s head or oculocephalic maneuver, the location
of hemorrhage is in ?
A. Putamen
B. Thalamus
C. Pons
D. Cerebellum

17 Excessive sweating (hyperhidrosis) is a feature of which of the
following CVA’s ?
A. Basal ganglia hemorrhage
B. Thalamic hemorrhage
C. Pontine hemorrhage
D. Cerebellar hemorrhage

18 Decerebrate rigidity is most frequent which of the following
hypertensive intraparenchymal hemorrhage ?

A. Basal ganglia hemorrhage
B. Thalamic hemorrhage
C. Pontine hemorrhage
D. Cerebellar hemorrhage

19 Cerebellar hemorrhages are characterized by ?
A. Occipital headache
B. Repeated vomiting
C. Ataxia of gait
D. All of the above

20 In mild cases of cerebellar hemorrhage, there may be no other
neurologic signs other than ?
A. Gait ataxia
B. Occipital headache
C. Repeated vomiting
D. Seizure

21 Which of the following about cerebellar hemorrhage is false ?
A. Forced deviation of eyes to opposite side
B. Paresis of conjugate lateral gaze toward side of hemorrhage
C. Usually develop over several hours
D. None of the above

22 Which of the following lobar hemorrhage causes arm weakness ?
A. Occipital hemorrhage
B. Left temporal hemorrhage
C. Parietal hemorrhage
D. Frontal hemorrhage

23 Which of the following is uncommon in lobar hemorrhages ?
A. Focal headaches
B. Vomiting
C. Drowsiness
D. Stiff neck

24 Which of the following is mainly affected in cerebral amyloid
angiopathy ?

A. Arterioles
B. Venules
C. Capillaries
D. All of the above
25Cerebral amyloid angiopathy affects mainly ?
A. Children
B. Adults
C. Elderly
D. All of the above

26 Cerebral amyloid angiopathy cause which of the following ?
A. Intraparenchymal hemorrhage
B. Lobar hemorrhage
C. Cerebellar hemorrhage
D. Subarachnoid hemorrhage

[MCQ] Intracranial hemorrhage- Part 1

I. Start the exam by click the “Start” button

Intracranial hemorrhage- Part 1

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