11-vascular diseases and trauma

Question 1

What are the most sensitive areas to ischemia or hypoxic/anoxic injury i nthe brain (4)

Answer 1

• the CA1 region of the hippocampus (Sommer sector)
• cerebral cortical layers 3, 5 and 6,
• the cerebellar Purkinje cells
• caudate and putamen

Question 2

HOW QUICKLY DOES NECROSIS Start after BF is stopped and what is the histological sign in the brain and how is this sign formed?

Answer 2

5 minutes
“red, dead, neurons” are formed by:
-lack of Nissl substance
-loss of nucleolus and nucleus

Question 3

What is 2 difference between TIA and stroke

Answer 3

focal ischemia with non-permanent signs and sx <24 hours = TIA;

focal ischemia with permanent signs and sx>24 hours = stroke

Question 4

What is the MC cause of intracerebral hemorrhage and what 3 regions in the brain do they MC occur

Answer 4

hypertension;

-in the basal ganglia/thalamus/pons

Question 5

What is, and what causes a Duret hemorrhage

Answer 5

Duret hemorrhages are midline hemorrhages in the midbrain and upper pons that occur secondary to uncal herniation. The Duret hemorrhage is due to tearing small penetrating vessels from the downward displacement

Question 6

what are the minute dilatations of arteriess in the brain called

Answer 6

Duret hemorrhages are midline hemorrhages in the midbrain and upper pons that occur secondary to uncal herniation. The Duret hemorrhage is due to tearing small penetrating vessels from the downward displacement

Question 7

ruptured berry aneurysms cause what type of hemorrhage; are due to what flaw?

Answer 7

cause SAH; are dt absence of the media of the vessel at a bifurcation

Question 8

what 4 diseases are assc with berry aneurysms

Answer 8

• ADPKD (review in renal pathology)
• connective tissue disorders (Marfan syndrome, etc)
• NF1
• fibromuscular dysplasia

Question 9

arteriovenous malformations cuases what type of hemorrhage

Answer 9

SAH

Question 10

rupture of middle meningeal artery causes what type of hemorrhage?

Answer 10

epidural

Question 11

epidural hematomas are usually associated with what event? clinically present how? findings?

Answer 11

skull fracture
present with a lucid interval
len-shaped imaging

Question 12

Subdural Hematoma:
-what mechanism?
-MC in what 2 populations?
what association?

Answer 12

• Due to shearing of parasagittal bridging VEINS
• common in the elderly or alcoholics;
• 75% are due to falls or assaults

Question 13

CSF fluid findings in bacterial and viral meningitis?

• pressure
• cell type
• protein
• glucose

Answer 13

Bacterial: 
-pressure: increased
-cell type: neutrophils
-protein: increased
-glucose: decreased
Viral: 
-pressure: normal/increased
-cell type: lymphocytes
-protein: normal/increased
-glucose: normal