Anatomy and Physiology XII Flashcards
What is an aneurysm?
An abnormal dilation of an artery due to weakening of a vessel wall (p.423)
Where does a berry aneurysm occur?
At the bifurcations of the circle of Willis (p.423)
What is the most common site for a berry aneurysm?
The bifurcation of the anterior communicating artery (p.423)
What is the most common complication associated with a berry aneurysm?
Rupture; most commonly causes subarachnoid hemorrhage or hemorrhagic stroke. Can also cause bitemporal hemianopia via compression of the optic chiasm (p.423)
What conditions are associated with berry aneurysms?
ADPKD, Ehlers-Danlos syndrome, Marfan’s syndrome (p.423)
Name some risk factors for berry aneurysms that are not associated with genetic syndromes.
Advanced age, hypertension, smoking, race (higher risk in blacks) (p.423)
What is a Charcot-Bouchard microaneurysm?
A brain aneurysm associated with chronic hypertension that affects the small vessels (p.423)
Name two common sites of Charcot-Bouchard microaneurysms.
Basal ganglia, thalamus (p.423)
Name two common sites of Charcot-Bouchard microaneurysms.
Basal ganglia, thalamus (p.423)
Rupture of what vessel causes an epidural hematoma?
Middle meningeal artery (p.424)
The middle meningeal artery is a branch of what artery?
Maxillary artery (p.424)
Fracture to what bone most frequently causes an epidural hematoma?
Temporal bone (p.424)
Describe the signs and symptoms consistent with epidural hematoma?
Lucid interval; rapid expansion under systemic arterial pressure and transtentorial herniation (p.424)
What nerve palsy is most common in epidural hematoma?
CN III palsy (p.424)
What findings are present on CT of an epidural hematoma?
Biconvex (lentiform), hyperdense blood collection not crossing suture lines. Can cross falx and tentorium (p.424)
Rupture of what vessel causes a subdural hematoma?
Rupture of the bridging veins (p.424)
Describe the development of a subdural hematoma.
Slow venous bleeding (less pressure so hematoma develops over time) (p.424)
In what patient population are subdural hematomas most commonly seen?
Elderly individuals, alcoholics, blunt trauma vicitims, shaken babies (p.424)
What factors may predispose someone to subdural hematoma?
Brain atrophy, shaking, whiplash (p.424)
What findings are present on CT of a subdural hematoma?
Crescent shaped hemorrhage that crosses suture lines. Midline shift present that cannot cross the falx or tentorium (p.424)
Compare and contrast CT findings of epidural vs subdural hematoma.
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)
What causes a subarachnoid hemorrhage?
Rupture of an aneurysm (berry (saccular)), or an AVM (p.424)
What is the timecourse of a subarachnoid hemorrhage?
Rapid time course where patients complain of the worst headache of my life (p.424)
Describe clinical findings in a patient with a subarachnoid hemorrhage.
Bloody or yellow (xanthochromic) spinal tap; 2-3 days afterwards risk of vasospasm due to blood breakdown and rebleed (p.424)
What clinical findings associated with subarachnoid hemorrhage are and are not visible on CT?
Vasospasm 2-3 days after bleed due to blood breakdown is NOT visible on CT; rebleed is visible on CT (p.424)
