Certified Neuroscience Registered Nurse (CNRN) Practice Exam

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Which group of people has the greatest risk of intracerebral hemorrhage (ICH)?

  1. Patients with a history of hypertension

  2. Patients with unruptured intracerebral AVMs

  3. Patients recovering from stroke

  4. Patients with head trauma

The correct answer is: Patients with unruptured intracerebral AVMs

The group with the greatest risk of intracerebral hemorrhage (ICH) consists of individuals with unruptured intracerebral arteriovenous malformations (AVMs). AVMs are abnormal connections between the arteries and veins in the brain, which can lead to weakened blood vessel walls. When these walls are compromised, the risk of spontaneous bleeding increases significantly. Although hypertension, head trauma, and recovering strokes are known risk factors for ICH, the anatomical vulnerabilities presented by AVMs make this population particularly susceptible to bleeding events. In patients with unruptured AVMs, the presence of high blood flow and pressure through the abnormal vessels can result in rupture, leading to an ICH. Thus, while the other groups may also face risks, the specific nature and presentation of AVMs position them as having a higher likelihood of intracerebral hemorrhage compared to the others.