Blood vessels and pathology

Question 1

What are the two major blood vessels that supply the brain?

Answer 1

Internal carotids and vertebral arteries

Question 2

What is an AV malformation?

Answer 2

It is an irregular connection between arteries and veins with NO capillary bed in between

Question 3

What is an aneurysm?

Answer 3

Site(s) of weakening in the arterial wall, often near points of bifrucation of arteries (in the circle of willis)

Question 4

What are the 3 types of aneurysms?

Answer 4

fusiform

saccular (Berry aneurysms)

Irregularly shaped

Question 5

Where in the circle of Willis is the most common site of aneurysm?

Answer 5

anterior communicating artery

Question 6

What is/are common symptoms of an aneurysm in the anterior communicating artery?

Answer 6

Compression of the optic chiasm causing visual defects

Question 7

What is/are common symptoms of an aneurysm in the posterior cerebral artery?

Answer 7

Compression of CN III causing ptosis, lateral deviation of the eye, and the dilated pupil

Question 8

What is a hemorrhagic stroke?

Answer 8

Hemorrhagic stroke occurs when an aneurysm bursts and blood leaks out and comes in contact with surroudning tissue. This blood causes swelling and pressure and damages the surrounding cells

Question 9

What is an ischemic stroke?

Answer 9

Ischemic stroke is caused when insufficient blood is delivered to the brain

Question 10

What are watershed zones? What are watershed infarcts? What are the two watershed areas in the brain?

Answer 10

Watershed zones are regions that recieve blood supply from distal ends of two arterial systems

In the setting of low blood pressure, blood can’t reach these areas resulting in infarction of the watershed zone

ACA-MCA watershed and the MCA-PCA watershed

Question 11

What areteries supply the precentral and postcentral gyri? What portions?

Answer 11

The ACA feed the trunk and lower extremities

The MCA feeds the arms and upper extremities

Question 12

What are the lenticulostriate arteries and what artery do they branch from?

Answer 12

They feed the basal ganglia and the internal capsule

They branch from the MCA

Question 13

What is the anterior choroidal artery? Where does it branch from?

Answer 13

Anterior choroidal artery supplies the choroid plexus in the lateral ventricles

It branches from the middle cerebral artery

Question 14

What blood vessel supplies the majority of the dura? What artery does it branch from? What foramen in the skull does it pass through?

Answer 14

middle meningeal artery

branches from the maxillary artery (from the external carotid artery)

foramen spinosum

Question 15

The ______, located laterally on the skull, contains the frontal, parietal, sphenoid, and temporal bones. Trauma to this area can tear the middle meningeal artery

Answer 15

Pterion

Question 16

If the middle meningeal artery is torn (caused by trauma to the pterion), what type of hematoma is formed? What sign is seen on imaging?

Answer 16

epidural hematoma

Lens-shaped

Question 17

What does the anterior cerebral artery supply? What deficits can be seen in ACA occlusion?

Answer 17

(blood supply is indicated in picture)

contralateral limb weakness and sensory loss, frontal lobe dysfunction (flat affect, apraxia[inability to perform purposeful function], abulia[absence of will power], and incontinence

Question 18

What is alien hand syndrome?

Answer 18

involuntary movements of the contralateral hand and arm in a ACA stroke

Question 19

What can an occlusion to the middle cerebral artery cause? If the MCA stroke occurs in the patient’s dominant hemisphere, what can occur?

Answer 19

contralateral hand and face weakness and upper quadrent visual field loss (visual pathway moves through parietal and temporal lobes towards occipital lobe)

Dominant hemisphere is usually left; aphasia (Broca and Wernicke)

Question 20

What happens when the lenticulostriate arteries are occluded?

Answer 20

devastating contralateral body weakness (supply the basal ganglia - only motor)

Question 21

What happens if the basilar artery is occluded?

Answer 21

Damage to the long tracts in the pons leading to “locked-in syndrome” (quadriplegia and inability to move the facial muscles; awareness, mentation, and sensation are intact)

Question 22

What happens if the pontine arteries are occluded?

Answer 22

contralateral weakness

Question 23

What happens if the labyrinthe arteries are occluded

Answer 23

ipsilateral hearing loss

Question 24

What happens if the posterior cerebral artery is occluded?

Answer 24

contralateral visual field defects

Question 25

What happens if the anterior spinal artery is occuleded?

Answer 25

if occlusion occurs at the level of the medulla, contralateral motor and sensory loss

If the occlusion happens at the spinal cord, bilateral motor and sensory loss

Question 26

What happens if the posterior spinal artery is occluded?

Answer 26

disruption of dorsal column (proprioception, deep touch, and vibration)

Question 27

What happens if the posterior inferior cerebellar artery is occluded?

Answer 27

sensory loss from ipsilateral face, loss of balance, and motor deficits of the pharynx and larynx