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NEURO 210 > Brain Circulation and Strokes > Flashcards

Brain Circulation and Strokes Flashcards

1
Q

What is a stroke?

A

Acute neurological impairment due to ischemia or hemorrhage.

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2
Q

What is the most common stroke?

A

Ischemic strokes.

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3
Q

What is an ischemic stroke?

A

Acute neurological deficits caused by impaired blood flow to the nervous system.

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4
Q

What scans are used to image strokes? Why?

A

MRI and CT scans, because they can detect brain density changes as well as presence of blood.

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5
Q

Who is more susceptible to stroke at a younger age? (M or F)

A

Male

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6
Q

Who is more susceptible to stroke at an older age? (M or F)

A

Female.

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7
Q

Through what arteries does blood flow to the brain? Which are present in the posterior plane? Which are present in the anterior plane?

A

2 Carotid arteries in the anterior plane. 2 Vertebral arteries in the posterior plane.

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8
Q

What causes impaired blood flow to the brain? (4)

A
  1. Vessel problems.
  2. Heart problems.
  3. Blood problems.
  4. Mitochondial disease.
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9
Q

What CBF level is considered normal?

A

60-50 ml/100g/min.

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10
Q

What is the threshold CBF past which synaptic transmission is halted?

A

20ml/100g/min.

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11
Q

During a stroke, what is the region of the brain that faces reversible damage that can recover with suboptimal function if CBF is restored?

A

The penumbra.

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12
Q

During a stroke, what is the region of the brain that obtains irreversible damage even when CBF is restored?

A

Infarct core.

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13
Q

At what CBF level does the infarct core develop?

A

12ml/100g/min.

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14
Q

What occurs to the brain when it is ischemic? How does this occur?

A 
Cellular injury and death:
Apoptosis
Excitotoxicity from glutamate
Inflammation
Oxidative stress
Mitochondrial dysfunction
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15
Q

What is the function of the BBB? What cells is it composed of?

A

FXN: Limit entry of blood products into the brain.
Composed: astrocytes, endothelial cells, pericytes, neurons.

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16
Q

What drug is used to break down an ischemic stroke blood clot? How does it do this?

A

tPA: converts plasminogen into plasmin to break down fibrin (clots).

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17
Q

What is TIA? How is it diagnosed?

A

Transient ischemic attack,

-Patient completely recovers within 24 hours, no infarct core present in CT or MRI.

18
Q

What artery supplies most of the brain? Which region of the sensory/motor cortex does it nourish?

A

Middle cerebral artery; the arm.

19
Q

What artery nourishes the occipital lobe?

A

Posterior cerebral artery.

20
Q

What are the unique symptoms of an MCA ischemic stroke?

A

Numbness in the arms.

21
Q

What are the unique symptoms of a PCA ischemic stroke?

A

Vision problems/blindness.

22
Q

What are the unique symptoms of an ACA ischemic stroke?

A

Numbness in legs.

23
Q

What is a lacunar stroke?

A

A stroke resulting from obstruction in lacunar vessels that stem from MCA. Causes defciits in the basal ganglia.

24
Q

What is the treatment for an acute stroke?

A
  1. ABC: airway breathing and circulation.
  2. IV tPA or endovascular therapy to remove clot.
  3. Neuroprotective factors put in place.
25
Q

How are ischemic strokes prevented?

A

Treatment of vascular risk factors, administrations of antiplatelets/anticoagulants.

Takeaway: treat underlying cause.

26
Q

What criteria in patients best suit endovascular therapy?

A
  1. Small infarct core.

2. Large artery occlusions (not quickly broken down by tPA)

27
Q

What is the most common/important cause of stroke?

A

Hypertension.

28
Q

What is carotid atherosclerosis? How is it treated?

A

Plaque buildup in the carotid artery causing thrombosis; treated by carotid endarterectomy or stent.

29
Q

What is a carotid/vertebral dissection? How to treat?

A

Occlusion of the CA or VA caused by blood clot formation due to tear in arterial wall, treated by anticoagulants/antiplatelets.

30
Q

What is small vessel lacunar stroke caused by?

A

Hypertension and diabetes or microvascular disease.

31
Q

How is small vessel lacunar stroke treated?

A

Antiplatelet.

32
Q

What is a cardioembolic stroke? What is the most common cause/risk factor?

A

A clot that migrates from the heart to the brain. The highest risk factor is atrial fibrillation.

33
Q

How is a cardioembolic stroke treated?

A

Anticoagulants

34
Q

What is atrial fibrillation?

A

Irregular contraction of atria that encourages the formation of clot in atrium.

35
Q

How do anticoagulants differ from antiplatelets?

A

Anticoagulants block coagulation cascade to prevent clotting, antiplatelets prevent platelets from adhesing to eachother

36
Q

What is a hemorrhagic stroke?

A

Neurological deficit caused by bleeding occuring inside or around the brain tissue.

37
Q

What are the subtypes of hemorrhagic strokes?

A

Epidural, subdural, subarachnoidal, intercerebral.

38
Q

How do intercerebral hemorrhages present?

A

Similar to ischemic strokes

-headache, altered level of consciousness.

39
Q

What is the main cause of IntC.H Stroke?

A

Hypertension.

40
Q

How do subarachnoid hemorrhagic strokes present?

A

Sudden headache, neck stiffness, altered level of consciousness, cranial nerve 3 palsy (no pupil dilation).

41
Q

What is the major cause of subarachnoid strokes?

A

Aneurysm ruptures.

42
Q

How are aneurysms treated?

A

Clipping or coiling to prevent bursting.

NEURO 210 (13 decks)

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