whats the pathophysiology of the subdural hematoma with chrnoic aspirin ingstn??

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whats the pathophysiology of subdural hemorrhage in a patient receiving aspirin for long term and in an alcoholic abuser? why not intracerebral/epidural hemorrhage at first position?

Also whats the pathoiphysiology of intracerebral hemorrhage in cocaine, amphetamine? and why not subdural/epidural hemorrhage at first position?

anyone would like to explain please.
best regards. John

please anyone help me with above questions.

because venous vs arterial (^SBP with uppers)?

Chronic alcohol abuse causes brain atrophy which increases free space between dura and brain and likelihood of tearing of bridging veins with acceleration deceleration injury

Epidural is traumatic

Intracerebral associated with hypertension

Cocaine, amphetamine increases BP and therefore intracerebral hemorrhage is more likely

Have no clue about aspirin

I'm not sure the exact pathology, but aspirin is an anticoagulant that irreversibly blocks platelet's ability to clot. I assume that most brain bleeds are from shearing forces and not blunt trauma, so the flimsy veins would be more likely to sever and need clotting than the muscular arteries.

http://www.ncbi.nlm.nih.gov/pubmed/1584433

Originally Posted by Ycut

Chronic alcohol abuse causes brain atrophy which increases free space between dura and brain and likelihood of tearing of bridging veins with acceleration deceleration injury

Epidural is traumatic

Intracerebral associated with hypertension

Cocaine, amphetamine increases BP and therefore intracerebral hemorrhage is more likely

Have no clue about aspirin

Intracerebral also notably AV-malformation and amyloid angiopathy.

Originally Posted by witzelsucht

because venous vs arterial (^SBP with uppers)?

i didnt get this. i am sorry. would you please elaborate that sentence a little bit more? thanks you.

Originally Posted by Ycut

Chronic alcohol abuse causes brain atrophy which increases free space between dura and brain and likelihood of tearing of bridging veins with acceleration deceleration injury

Epidural is traumatic

Intracerebral associated with hypertension

Cocaine, amphetamine increases BP and therefore intracerebral hemorrhage is more likely

Have no clue about aspirin

thanks a million. these explanations are quite simple and that really helped. thanks again. the only one left is aspirin. i hope you would come up with this soon.

Originally Posted by pirsquared

I'm not sure the exact pathology, but aspirin is an anticoagulant that irreversibly blocks platelet's ability to clot. I assume that most brain bleeds are from shearing forces and not blunt trauma, so the flimsy veins would be more likely to sever and need clotting than the muscular arteries.

http://www.ncbi.nlm.nih.gov/pubmed/1584433

thanks man, i have read that article. So, does it mean aspirin can only cause subdural hemorrhage when we put on aspirin for long term in an already head injured patient (i mean wen there is already a risk factor present)? otherwise its not likely to have subdural hemorrhage with aspirin without a prior risk factor?


p.s. thanks to Phloston to add a few more reasons.

Originally Posted by sylhet

thanks man, i have read that article. So, does it mean aspirin can only cause subdural hemorrhage when we put on aspirin for long term in an already head injured patient (i mean wen there is already a risk factor present)? otherwise its not likely to have subdural hemorrhage with aspirin without a prior risk factor?

I am hypothesizing here, but my take is long-term aspirin is more likely to lead to this complication because it will eventually muck up most of the platelets and decrease the ability to stop a bleed. Perhaps, if someone already has a risk factor, they are more likely to bleed, and thus more likely to need to be able to clot. I wish I could help you more, but that's as far as I am comfortable with right now.

Originally Posted by pirsquared

I am hypothesizing here, but my take is long-term aspirin is more likely to lead to this complication because it will eventually muck up most of the platelets and decrease the ability to stop a bleed. Perhaps, if someone already has a risk factor, they are more likely to bleed, and thus more likely to need to be able to clot. I wish I could help you more, but that's as far as I am comfortable with right now.

i appreciate your explanation/hypothesis. and i think youre right. :-) thanks a lot for your time. be blessed.