Blood supply, Hemorrhage and herniation

Question 1

Epidural hematoma
Beeding into:
Common site:
Source:

Answer 1

Between skull and periosteal layer of dura mater
Pterion or squamous portion of temporal bone
middle meningeal a.

Question 2

Subdural hematoma
Bleeding into:
source:

Answer 2

between dura and arachnoid

VENOUS source

Question 3

Subarachnoid hemorrhage
common finding:
source:

Answer 3

common finding in severe head injury, more common is rupture of aneurysm
source: circle of willis; cerebral a

“thunderclap headache”

Question 4

Intracerebral (subpial) hemorrhage
(hemorrhagic stroke)
source:

Answer 4

bleeding within brain substance (stroke)
usually from middle cerebral a

clinical - hypertension or degenerative arterial disease

Question 5

Subfalcine herniation

Answer 5

also called a cingulate or falcine or falx herniation
supratentorial compartment: displaces brain tissue under falx cerebri
may compress anterior cerebral a (ACA)
frontal lobe and parietal love
may evolve into transtentorial herniation

Question 6

Transtentorial herniation

Answer 6

also called central herniation
displaced downward toward the tentorial notch
Compromises upper brainstem, CN3 and possibly lower structures

may compress basilar a and posterior cerebral as.

Question 7

Uncal Herniation

Answer 7

Uncus (and frequently portions of parahippocampal gyrus) extruded over the edge of tentorium cerebelli and through the tentorial notch

Ipsilateral CN3 palsy, contralat hemoplasia

Kernohan syndrome

Question 8

Tonsillar herniation

Answer 8

Cerebellar tonsils through foramen magnum
compression of medulla and upper cervical spinal cord

medulla- cardiac and respiratory centers

Question 9

CN2 can be affected by:

Answer 9

ICA
anterior cerebral a
anterior communicating a

Question 10

CN3 can be affected by:

Answer 10

superior cerebellar
posterior cerebral
posterior communicating

Question 11

CN6 can be affected by:

Answer 11

AICA
labyrinthine (internal acoustic) a

Question 12

CN5 can be affected by:

Answer 12

superior cerebellar a

Question 13

CN7 can be affected by:

Answer 13

AICA

Question 14

Anterior cerebral A. supplies what surfaces:

Answer 14

most of the medial and superior surface of the frontal and parietal lobes

Question 15

Middle cerebral a. supplies what surfaces:

Answer 15

lateral surface of frontal and parietal lobes and superior part of temporal lobe

Question 16

Posterior cerebral a. supplies what surfaces:

Answer 16

occipital lobe and inferior temporal lobe

Question 17

what are the border zones

Answer 17

areas in between arteries

susceptible to damage under conditions of sudden systemic hypotension or hypoperfusion

Question 18

A1 of ACA

Answer 18

(precommunicating segment)

ICA to anterior communicating a

Question 19

A2 of ACA

Answer 19

(infracallosal segment)

anterior communicating a to where rostrum and genu of corpus callosum meet

Question 20

A3 of ACA

Answer 20

(precallosal segment)

arches of genu of corpus callosum to where vessels turn caudal

Question 21

A4 of ACA

Answer 21

(supracallosal segment)

superior to corpus callosum

Question 22

A5 of ACA

Answer 22

(postcallosal segment)

caudal to corpus callosum

Question 23

M1 of MCA

Answer 23

(sphenoidal or horizontal segment)

ICA to bifurcation at insula

Question 24

M2 of MCA

Answer 24

(insular segment)

bifurcation at insula to circular sulcus of insula

Question 25

M3 of MCA

Answer 25

(opercular segment)

circular sulcus of insula to external surface of lateral fissure

Question 26

M4 of MCA

Answer 26

(cortical segment)

on the cortex

Question 27

P1 of PCA

Answer 27

basilar a bifurcation to posterior communicating a

Question 28

P2 of PCA

Answer 28

posterior communicating to around the midbrain

Question 29

P3 of PCA

Answer 29

within quadrigeminal cistern

Question 30

P4 of PCA

Answer 30

on the cortex

Question 31

which spinal artery supplies most of the spinal cord

Answer 31

anterior spinal a (2/3)

Question 32

what anastamoses the anterior and posterior spinal as

Answer 32

arterial vasocorona (AVC)