Anatomy and Physiology XII

Question 1

What is an aneurysm?

Answer 1

An abnormal dilation of an artery due to weakening of a vessel wall (p.423)

Question 2

Where does a berry aneurysm occur?

Answer 2

At the bifurcations of the circle of Willis (p.423)

Question 3

What is the most common site for a berry aneurysm?

Answer 3

The bifurcation of the anterior communicating artery (p.423)

Question 4

What is the most common complication associated with a berry aneurysm?

Answer 4

Rupture; most commonly causes subarachnoid hemorrhage or hemorrhagic stroke. Can also cause bitemporal hemianopia via compression of the optic chiasm (p.423)

Question 5

What conditions are associated with berry aneurysms?

Answer 5

ADPKD, Ehlers-Danlos syndrome, Marfan’s syndrome (p.423)

Question 6

Name some risk factors for berry aneurysms that are not associated with genetic syndromes.

Answer 6

Advanced age, hypertension, smoking, race (higher risk in blacks) (p.423)

Question 7

What is a Charcot-Bouchard microaneurysm?

Answer 7

A brain aneurysm associated with chronic hypertension that affects the small vessels (p.423)

Question 8

Name two common sites of Charcot-Bouchard microaneurysms.

Answer 8

Basal ganglia, thalamus (p.423)

Question 9

Name two common sites of Charcot-Bouchard microaneurysms.

Answer 9

Basal ganglia, thalamus (p.423)

Question 10

Rupture of what vessel causes an epidural hematoma?

Answer 10

Middle meningeal artery (p.424)

Question 11

The middle meningeal artery is a branch of what artery?

Answer 11

Maxillary artery (p.424)

Question 12

Fracture to what bone most frequently causes an epidural hematoma?

Answer 12

Temporal bone (p.424)

Question 13

Describe the signs and symptoms consistent with epidural hematoma?

Answer 13

Lucid interval; rapid expansion under systemic arterial pressure and transtentorial herniation (p.424)

Question 14

What nerve palsy is most common in epidural hematoma?

Answer 14

CN III palsy (p.424)

Question 15

What findings are present on CT of an epidural hematoma?

Answer 15

Biconvex (lentiform), hyperdense blood collection not crossing suture lines. Can cross falx and tentorium (p.424)

Question 16

Rupture of what vessel causes a subdural hematoma?

Answer 16

Rupture of the bridging veins (p.424)

Question 17

Describe the development of a subdural hematoma.

Answer 17

Slow venous bleeding (less pressure so hematoma develops over time) (p.424)

Question 18

In what patient population are subdural hematomas most commonly seen?

Answer 18

Elderly individuals, alcoholics, blunt trauma vicitims, shaken babies (p.424)

Question 19

What factors may predispose someone to subdural hematoma?

Answer 19

Brain atrophy, shaking, whiplash (p.424)

Question 20

What findings are present on CT of a subdural hematoma?

Answer 20

Crescent shaped hemorrhage that crosses suture lines. Midline shift present that cannot cross the falx or tentorium (p.424)

Question 21

Compare and contrast CT findings of epidural vs subdural hematoma.

Answer 21

Epidural: lentiform, hyperdense blood collection that does NOT cross suture lines but can cross the falx and tentorium; Subdural: crescent shaped hemorrhage that crosses suture lines and DOES cause a midline shift but does not cross the falx or tentorium (p.424)

Question 22

What causes a subarachnoid hemorrhage?

Answer 22

Rupture of an aneurysm (berry (saccular)), or an AVM (p.424)

Question 23

What is the timecourse of a subarachnoid hemorrhage?

Answer 23

Rapid time course where patients complain of the worst headache of my life (p.424)

Question 24

Describe clinical findings in a patient with a subarachnoid hemorrhage.

Answer 24

Bloody or yellow (xanthochromic) spinal tap; 2-3 days afterwards risk of vasospasm due to blood breakdown and rebleed (p.424)

Question 25

What clinical findings associated with subarachnoid hemorrhage are and are not visible on CT?

Answer 25

Vasospasm 2-3 days after bleed due to blood breakdown is NOT visible on CT; rebleed is visible on CT (p.424)