2: Cerebrovascular Disease

Question 1

Four MC Cerebrovascular disorders

Answer 1

1. Global ischemia
2. Embolism
3. Hypertensive intraparenchymal hemorrhage
4. Ruptured aneurysm

Question 2

When blood flow to the brain is reduced, survival depends on what three things

Answer 2

1. Collateral circulation
2. Duration of ischemia
3. Magnitude and rapidity of flow reduction

Question 3

Examples of global vs focal ischemia in the brain

Answer 3

1. Global: cardiac arrest, shock, severe hypotension

2. Emboliform or thrombotic arterial occlusion, vasculitides, atherosclerosis in HTN

Question 4

Shape of necrosis from a watershed infarct

Answer 4

Sickle-shaped band

Question 5

Hemorrhagic conversion

Answer 5

Fragile vessels in an ischemic infarct rupture, leading to secondary hemorrhage

Question 6

Ischemic stroke

Answer 6

Inadequate blood supply -> infarct of brain tissue

Question 7

Binswanger Dz

Answer 7

large area of subcortical white matter undergoes myelin and axon loss

Question 8

Charcot-Bouchard microaneurysms

Answer 8

Chronic HTN -> minute <300uM aneurysms in the basal ganglia

Question 9

Three things to consider if a young pt has a stroke

Answer 9

Arterial dissection, PFO, hypercoagulability