Makindo Medical Notes

🧠 Ischaemic Stroke

Loss of blood supply to brain tissue, usually due to thrombus or embolus.

Dense R MCA: Hyperdense MCA sign = acute thrombus.

Dense L MCA + ACA infarction with oedema: Shows early swelling, loss of grey–white differentiation.

🩸 Haemorrhagic Stroke

Bleeding within the brain parenchyma – high density area on CT.

Cerebellar haemorrhage: Risk of brainstem compression, often needs neurosurgical review.

🌊 Subarachnoid Haemorrhage (SAH)

Blood in basal cisterns/sulci, usually from ruptured aneurysm. "Thunderclap headache".

💉 Subdural Haematoma (SDH)

Crescent-shaped bleed between dura and arachnoid; usually due to torn bridging veins.

Large left acute + subacute SDH with midline shift: Emergency – may need burr hole or craniotomy.

🩸 Epidural Haematoma (EDH)

Biconvex/lentiform bleed, often after temporal bone fracture with middle meningeal artery injury.

💨 Pulmonary Embolism Imaging

CT Pulmonary Angiogram (CTPA): Saddle embolus at bifurcation of pulmonary arteries.

VQ Scan: Mismatched perfusion defects suggest PE when ventilation is preserved.

🫁 Cystic Fibrosis

Bronchiectasis, mucus plugging, and hyperinflated lungs.

🎯 Cannonball Metastases

Multiple round pulmonary metastases (renal, choriocarcinoma, thyroid, melanoma).