6 Cerebral Vasclar Disease Stroke And Hemorrhage Flashcards
Strokes:
It’s a _____ of blood supply to an area of the brain, resulting in loss of neurological function.
Reduction of the flow rate by __% causes neurons to stop signaling. Reduction to about __% for more than a few minutes initiates necrosis of involved brain tissue.
A necrotic region of tissue is called an ______
An abrupt indecent of vascular insufficiency is called a _____
Bleeding into or around the brain can have stroke-like effects.
Loss
60%. 20%
Infarct
Stroke
Are strokes are more common in men than women?
_______ with age.
Two types of strokes:
_________(ischemic) (70-80% of cases)
Thrombotic and _______
Hemorrhagic (not due to trauma)
Intracerebral hemorrhage and ____________ hemorrhage
Men!
Increases (peak around 80-84yrs)
Occlusive. Embolic
Subarachnoid
Time is of the essence in a stroke!
A ________ is the region surrounding the area of permanent tissue damage. It will survive is you treat rapidly and appropriately. You have up to _hrs to treat!
Penumbra. 3hrs
Occlusive/ischemic strokes:
__________:
Clot forms locally, over an atherosclerotic region. Often has prodromes and transient ischemic attacks (TIA).
_______:
Blockage by thrombi formed elsewhere. Thrombus detaches, and lodges in artery. Often no prodromes.
Watershed _______:
Hypoxia due to insufficient blood supply. Hypotension. Affects vulnerable sites
Thrombotic
Embolic
Watershed infarct
Hemorrhagic strokes:
___________ hemorrhage:
Most commonly caused by ANEURYSM RUPTURE and arteriovenous malformation
____________ hemorrhage:
Most commonly caused by HYPERTENSION and arteriovenous malformation
Subarachnoid hemorrhage
Intracerebral Hemorrhage
Ischemia and hemorrhage lead to virtually the same clinical presentation, the only difference is the _________.
Ischemic (reduced ______ supply): leads to decreased oxygenation of brain tissue (hypoxia) which can progress to tissue necrosis (________)
Hemorrhagic- ________ of a blood vessel. If a severe headache is associated with a stroke, symptoms indicate this kind of stroke
Mechanism
Blood. Infarction
Rupture
A ________ ischemic attack is a vascular event similar to a stroke’s symptoms.
The crucial difference is that the deficits of a TIA persist for only a few minutes to hours and have a ________ recovery.
Transient monocular blindness or amaurosis fugax, is a classic example of ___ syndrome. Caused by emboli detaching from internal carotid artery and enter the ________ artery thus rendering the retina temporarily ischemic.
Often precede a stroke!
Transient
Complete
TIA. Ophthalmic.
Ischemic stroke:
What’s the most common location where an ischemic stroke could occur?
_________ of the brain is the biggest immediate danger (herniation). The main symptoms are contralateral hemiparesis and sensory loss predominately in the ____ and ______ extremity. ***
______ strokes involve the MCA. Pure motor, sensory, isolated symptoms of MONOPARESIS and ISOLATED ________ LOSS**
MCA
Swelling. Face and upper extremity **
Lacunar. Sensory
Strokes involving the anterior cerebral artery
Main symptoms include:
Contralateral hemiparesis in _____ extremity. Contralateral sensory loss in _____ extremity.
The give-away would be the _______ incontinence.
Lower. Lower
Urinary
Strokes involving vertebral-basilar system
Main symptoms:
Ipsilateral ______ loss in the face
The main give away point is _______, ataxia!
The posterior inferior cerebellar artery supplies the lateral ______. It’s occlusion can cause Wallenberg Syndrome.
Sensory
Vertigo
Medulla
The main symptoms involving a posterior cerebral artery include:
Gaze _______.
______ fields defects. Hemianopsia-where the eye deviates towards the side of the lesion to compensate. ‘Eye looks towards the lesion”
Paralysis
Visual
Locations and causes of an intracranial hematoma:
________-rupture of a meningeal artery from blow to head.
________-rupture of a bridging vein. Accident where head hits hard surface.
__________-most often aneurysm rupture. “Worst headache of my life”
Epidural
Subdural
Subarachnoid
What hematoma is caused when an arterial bleed creates a blood-filled space between the bone and dura matter? Caused from a blow to the head.
Diagnosis:
Head CT scan is best choice. It is ____ shaped.
Which hematoma is a subdural rupture of bridging veins between dura and arachnoid matter? Often seen in shaking baby syndrome, alcoholics, and the elderly
Which hematoma is caused by a ruptured berry aneurysm? Old age, smoking, and higher rates in African Americans. Presents as “worst headache of my life” and CN ___ paralysis.
Diagnosis:
Bloody spinal tap. CT scan crescent shaped. Removed by craniotomy
Epidural hematoma
Lens
Subdural hematoma
Subarachnoid. CN III oculomotor
(LO) Describe how a subarachnoid hemorrhage starts. What types of vessels rupture?
What are some typical causes or risk factors?
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(LO) What type of vessel ruptures in a subdural hemorrhage? What are some typical causes? Describe which tissues that contain the hematoma. What is the shape of the hematoma as seen in a CT or MRI scan? Why does this shape occur?
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