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Year 2 LCRS Neurology > 3: Blood supply of the brain > Flashcards

3: Blood supply of the brain Flashcards

1
Q

For which percent of the body weight and cardiac output does the brain makes up?

A

Only 2% of body weight but

10- 20% of cardiac output

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2
Q

Which two major arteries supply the brain with blood?

A
  • Internal carotid artery
  • Vertebral arteries
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3
Q

What is the circle of Willis?

A

Anastomosis of arteries supplying the brain

–> allows collater circulation in the cerebral circulation

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4
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10
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11
Q

Summarise the overall venous drainage of the brain

A

—Cerebral veins

—–> Venous sinuses (in subarachidonic space) –>

— –> Dura mater

—Internal jugular vein

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12
Q

What is a —Cerebrovascular accident (CVA)?

A

A Stroke

rapidly developing focal disturbance of brain function of presumed vascular origin and of >24 hours duration

–> 85% infarction, 15% hemmorage

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13
Q

What is a Transient Ischaemic Attack (TIA)?

A

rapidly developing focal disturbance of brain function of presumed vascular origin that resolves completely within 24 hours

–> warning sign: patients are at hight risk of getting a stroke!

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14
Q

What is an infarction?

A

—Degenerative changes which occur in tissue following occlusion of an artery

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15
Q

What is cerebral ischemia?

A

—Lack of sufficient blood supply to nervous tissue resulting in permanent damage if blood flow is not restored quickly

—

— hypoxia/anoxia

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16
Q

What are posiible causes for an occlusion

A
  • Thrombus (blood cloth at site of formation)
  • Embolus (any other substance or other blood cloth formed in another place)
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17
Q

What are the main risk factors for stroke?

A
  • Age
  • Hypertension
  • Cardiac disease
  • Smoking
  • Diabetes mellitus
18
Q

Which part of the brain is supplied by the anterior cerebral artery?

A

Medial two thirds of the Cortex

  • Medial prtions of frontal lobes
  • Superior medial parietal lobes
19
Q

Which part of the brain is supplied by the middle cerebral artery?

A

Lateral 2/3 of cortex + forebrain

20
Q

Which part of the brain is supplied by the posterior cerebral artery?

A

The occipital lobe (posterior part)

21
Q

Which symptoms might occur when ther is a blockage to the anterior cerebral artery?

A

Paralysis of

  • contralateral leg (more than arm)
  • face

Disturbance of intelect, executive function and judgement (–>abulia)

Loss of appropirate social behaviour

22
Q

Which symptoms might occur when there is a occlusion of the middle cerebral artery?

A

“Classic stroke”—

  • Contralateral hemiplegia (=hemiparesis): arm rather than leg
  • —Contralateral hemisensory (=altered sensation) deficits
  • —Hemianopia (optical disturbance (blurred/blindness)
  • —Aphasia (L sided lesion) (loss of speach)
23
Q

What is hemiplegia?

A

Hemiparesis

(half sided paralysis)

24
Q

What is hemianopia?

A

Visual field loss in a vertical line

25
Q

What is Aphasia

A

Loss of speach (can also be eiter efferent (understanding) or afferent (speaking))

26
Q

What is Broca’s aphasia?

A

It is expressice loss of speach

due to damage to the broca region

27
Q

What is Wernicke’s aphasia?

A

Receptive aphasia

  • loss of understnading of speech

–> due to damage to the Wernicke region of the brain

28
Q

How does a paitent with blockafe of the posterior cerebral artery might present?

A

—Visual deficits

  • homonymous hemianopia (hemianopic visual field loss on the same side of both eyes)
  • visual agnosia (impaired visual perception)
29
Q

What is a Lacunar Infarct?

A
  • —Lacune is a small cavity formed by tissue loss due to former strokes
  • —Appear in deep structures as a result of small vessel occlusion
  • —Deficit is dependent on anatomical location
  • Main risk factor: —Hypertension
30
Q

What are the characteristice of a subarachnoid hemorrhage?

A

Usually ruptured aneurysm

  • Rupture can be due to trauma
  • or spontaneous
31
Q

What are the characteristics of a intercerebral hemorrhage?

A

Usually spontaneous

  • closely linked to hypertension
32
Q

Explain the organisation of the dura mater in relation to the cerebral sinuses?

A

Dura surrounds the sinuses

33
Q

Compare a subdural vs. an extradural (epidural) haematoma

A

Subdural:

  • venous
  • slow
  • can be traumatic or spontaneous (more common in eldrely)

Extradural

  • arterial
  • quicker
  • usually traumatic (more common in young patients)
34
Q

Which symptoms would you expect with and occlusion of the anterior cerebral artery?

A

Supplies part of motor cortex to legs:

  • paralysis/weakness in contralateral leg
  • loss of sensation in contralateral leg
  • Abulia –> no motivation
  • inability to initiate the process of walking (gait appraxia)
  • urinary incontinence
35
Q

Where would you suspect someone to have a leasion if one presents with following symptoms:

  • paralysis/weakness in contralateral leg
  • loss of sensation in contralateral leg
  • Abulia –> no motivation
  • inability to initiate the process of walking (gait appraxia)
  • urinary incontinence
A

In the anterior cerebral artery

36
Q

Which symptoms would a patient present with when having an occklusion in the basilar artery?

A

Present with locked-in syndrome

37
Q

Which part of the brain dos the middle cerebral artery supply?

A
  • A lot of the lateral surface of the hemisphere
  • (location of Broca’s area i.e. language expression)
  • Inferior division supplies lateral temporal lobe (location of Wernicke’s area i.e. language comprehension)
  • Deep branches supply the basal ganglia as well as the internal capsule
38
Q

Which symptoms might someone present when there is an occlusion of the middle cerebral artery?

A
  • Paralysis + sensory loss of contralateral face and arm
  • Aphasia (dependant of side of brain if Broca of Wernicke) –> usually left
  • contralateral neglect syndrome
  • Contralateral homonymous hemianopsia is often present
39
Q

When someone presents with following symptoms: Where would you supect a leasion to be?

  • Paralysis + sensory loss of contralateral face and arm
  • Aphasia (dependant of side of brain if Broca of Wernicke) –> usually left
  • contralateral neglect syndrome
  • Contralateral homonymous hemianopsia is often present
A

Middle cerebral artery

40
Q

When someone is haveing an occulusion in the posterior cerebral artery, what do you expect the symptoms to be?

A

Supplies the: Occipital lobe, Basal ganglia in temporal lobe, Thalamus, lateral+3rd ventricle

  • Contralateral loss of pain and temperature sensations.
  • Visual field defects (contralateral hemianopia with macular sparing).
  • Prosopagnosia –> no recognition of faces
  • Ipsilateral deficits of oculomotor nerve,
  • Contralateral deficits of facial nerve (only lower face, upper face receives bilateral input), vagus nerve and hypoglossal nerve
41
Q

Someone presenting with following symptoms:

Where do you expect the leasion to be?

  • Contralateral loss of pain and temperature sensations.
  • Visual field defects (contralateral hemianopia with macular sparing).
  • Prosopagnosia –> no recognition of faces
  • Ipsilateral deficits of oculomotor nerve,
  • Contralateral deficits of facial nerve (only lower face, upper face receives bilateral input), vagus nerve and hypoglossal nerve
A

Posterior cerebral artery

42
Q

What is a Berry aneurism?

What does it cause?

A

It is a saccular aneurism in the brain

  • most common cause for sub-arachnoid haemorrhage

Year 2 LCRS Neurology (20 decks)

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