8 Cerebrovascular Diseases (Baumbach) Flashcards
What is ischemic/hypoxic encephalopathY?
generalized reduction in blood flow or P02
Name 3 things that can cause ischemic/hypoxic encephalopathy
hypotension
pulmonary disease
increased intracranial pressure
What areas are especially vulnerable to ischemic/hypoxic encephalopathy?
- watershed zones
- neurons of the hippocampus and purkinje cells
Where are the most likely sites of atherosclerosis affecting the brain?
internal carotid or cerebral arteries
If you see crystal shapes in the middle of an embolus what is it called?
cholesterol embolus
What are the 2 main categories of infarct in the brain
non-hemorrhagic
hemorrhagic
Non-hemorrhagic infarcts are usually due to ______ whereas hemorrhagic infarcts are usually due to _____ and result from _______
- thrombus
- embolus
- reperfusion
Acute stage of an infarct is defined as _______
less than 1 week
subacute stage of an infarct is defined as_______
1-4 weeks
Remote stage of an infarct is defined as ___
months-years
Name 5 changes seen in acute infarct stage
- coagulation necrosis (red neurons)
- axonal degeneration (spheroid bodies)
- cerebral edema
- vascular proliferation
- neutrophil response
What 2 changes will you see in subacute stage?
- macrophages
- reactive gliosis (gemistocytes)
What 2 changes will you see in the remote stage?
- cyst formation
- glial scarring
Name 3 things that can cause ischemic/hypoxic encephalopathy
hypotension
pulmonary disease
increased intracranial pressure
What areas are especially vulnerable to ischemic/hypoxic encephalopathy?
- watershed zones
- neurons of the hippocampus and purkinje cells
Where are the most likely sites of atherosclerosis affecting the brain?
internal carotid or cerebral arteries
If you see crystal shapes in the middle of an embolus what is it called?
cholesterol embolus
What are the 2 main categories of infarct in the brain
non-hemorrhagic
hemorrhagic
Premature infants are most likely to experience hemorrhage where?
germinal matrix hemorrhage
intraventricular hemorrhage
Name the perinatal asphyxia patterns associated with term infants
- selective vulnerability of oligodendrocytes
- periventricular leukomalacia
- multicystic encephalopathy
What is the clinical syndrome a survivor of perinatal asphyxia or trauma has?
cerebral palsy
Name the 3 most common sites of hypertensive hemorrhage
- basal-ganglia/thalamus (65%)
- pons (15%)
- cerebellum (10%)
Saccular aneurysms form at branch points and often are due to what?
abnormality/lack of internal elastic lamina
Where do most saccular aneurysms occur?
anterior communicating artery
Name the 3 types of vascular malformations
- arteriovenous malformation
- cavernous angioma
- telangiectasia
How do vascular malformations cause injury?
hemorrhage, seizure, local ischemic injury (“steal” phenomena)
Amyloid antipathy results from deposition of amyloid in the vessel wall. What are the familial forms of this?
Dutch (APP mutations)
Icelandic (cystatin C mutations)
What is CADASIL?
“Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy”
-associated with notch-3 mutations
What is MELAS?
Mitochondiral myopathy, Encephalopathy, Lactic Acidosis and Stroke like episodes
-associated with mitochondrial DNA mutations
