CVA-05 · Subarachnoid Hemorrhage and Vascular Malformations

Subarachnoid Hemorrhage and Vascular Malformations. Part of the Cerebrovascular / Stroke series of the Reflex PM&R Board Review podcast. Audio correction: In the audio: And the very first sign, the absolute canary in the coal mine is the pupil blowing open. It becomes fixed and dilated. — Correct: There is no fixed order in which the findings of an aneurysmal third-nerve palsy appear. Mydriasis, ptosis and eye deviation can arrive in any sequence, and aneurysmal palsies that spare the pupil are documented. Any acute acquired isolated third-nerve palsy in an adult gets prompt vascular imaging, CTA or MRA, whether or not the pupil is involved and whether or not the patient has diabetes. A painful pupil-involving palsy is still a PCOM aneurysm until imaging says otherwise; the pupil is not a screening gate. The written chapter is correct. Full correction register: https://www.reflexpmr.com/errata. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/CVA-05.