Anatomy-CNS Vasculature Flashcards
What type of stroke is more common? What type is more fatal?
Blockages are more common but bleeds are mor fatal.
What type of ischemic stroke will result in rapid onset of symptoms? What type develops slowly?
Arteriosclerosis and thrombus = slow development. Embolus = rapid progression
Why do patients that go into cardiac arrest have an increased risk for cytotoxic cerebral edema?
Cardiac arrest = less blood flow to CNS. Lack of energy to maintain ion pumps = swelling of cells in the brain and edema.
Angina is to MI as ____ is to stroke. What are the symptoms of this?
Transient Ischemic Attacks can be a warning sign for stroke. They present with motor, sensory, visual or memory loss.
What do you call memory loss due to transient ischemic attack that affects the hippocampus?
Transient global amnesia
What are you looking for on a CT image of a patient’s brain who has a hemorrhage or any type of cerebral edema?
Midline shift
What is the temporal progression of a CVA as you move from hours to days to weeks?
Immediately you have hemorrhage. After a few hours you have infarction. After a few days you have mass effect hematoma. After a few weeks you have mass effect edema.
What vessels are indicated below?
These are all branches from the vertebral artery. #1) Anterior Spinal Artery #2) PICA #3) Bulbar Branches
What vessels are indicated below?
These are branches off of the basilar artery. #1) Labyrinthine (to ear) #2) AICA
What blood vessels are indicated in the image below?
These are branches off of the basilar artery. Note that the posterior cerebral artery goes around the brainstem, the circumferential branches go into the brainstem and the superior cerebellar artery goes to the top of the cerebellum.
What areas of the brain are supplied by these branches of the basilar artery: AICA, Labyrinthine, Paramedian and Circumferential?
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A patient comes to see you in clinic and is having a stroke. His tongue is pushed out of his mouth to the right side. What artery was likely blocked?
The right paramedian artery blockade caused paramedian brain stem infarction. CN XII runs in this area and accounts for the tongue being pushed toward the side of the lesion.
What are the different divisions of the internal carotid artery?
Cervical then it becomes the petrous branch as it goes through the bone (note how the artery is not as opaque when traversing the bone) then it becomes the cavernous/sigmoid segment and then it becomes the supraclinoid segment (once it breaks through the cranial vault).
What are the 5 branches of the internal carotid artery?
Opthalmic, Anterior cerebral, middle cerebral, anterior choroidal and posterior communicating.
What’s in the Circle of Willis?
Anterior cerebral, posterior cerebral, anterior communicating, posterior communicating and a small segment of the internal carotid artery.
What areas are covered by the anterior cerebral artery?
Note that a deficit in the frontopolar artery may cause personality changes, deficit in the callosomarginal artery may cause sensorimotor loss in the lower extremities.
What areas are covered by the posterior cerebral artery?
Note that a deficit in the calcimine artery will cause visual field loss.
What deficits might you see in a patient with occlusion of the middle cerebral artery?
This is artery runs along the insula and then branches out of the lateral sulcus across the entire lateral side of the brain. Occlusion of this artery may result in sensorimotor loss in the entire homunculus, visual loss, hearing loss and if it is on the dominant side of the brain speech problems due to damage in Broca’s and Wernicke’s areas.
What do you suspect if the image you see below is distorted?
This is Sylvian Triangle. If this is distorted it tells you there is a mass effect going on and a possible tumor.
What arteries are represented in the image below?
Blue: anterior cerebral. Red: Middle cerebral. Turquoise: Posterior cerebral.
What artery was likely occluded in this patient? How would his symptoms present?
The middle cerebral artery. Note it was a more distal occasion because the internal capsule was spared. He would have felt sensorimotor loss to everything but his feet and legs.
Why does a deep infarction of the middle cerebral artery put the basal ganglia and internal capsule at risk for damage?
The middle cerebral artery gives off lenticulostriate arteries that penetrate the non-cortical deep structures of the brain. If the occlusion is before these branches, the deep structures of the brain will be damaged.
What artery was likely occluded in the patient whose image is shown below? How would he present with symptoms?
The anterior cerebral artery stays more superficial and medial, where the lesion is located. Symptoms would include sensorimotor loss to lower extremities.
