Cerebral hemorrhage

Question 1

how does pure ischemic infarction differ from ischemic stroke?

Answer 1

pure ischemic infarction = interstitial edema = resolve with out as much collateral damage as cytotoxic edema

Question 2

Where are the following most common?

1. Saccular Aneurysms
2. Giant Aneurysms
3. Mycotic aneurysm

Answer 2

1. Anterior circulation, most common cause of subarachnoid hemorrhage
2. MCA bifurcation - compression or embolize
3. IV drug users, subacute bacterial endocarditis

Question 3

How does a subarachnoid hemorrhage affect surrounding vessels? what are additional CNS fx?

Answer 3

cause vasospasm - Ischemic infarction

cause hydrocephalus from impaired CSF absorption

Question 4

multiple acquired microaneurysms
in basal ganglia, thalamus, pons

name, and cause?

Answer 4

Charcot-Bouchard aneurysm
caused by sustained hypertension

small hemorrhagic lacunes

Question 5

vary sized mass of distorted arteries and veins with thin waled vascular channels interspersed
have significant blood supply

Answer 5

Arteriovenous Malformations (AVM)

Question 6

small thin walled venous clusters without significant arterial supply
Congenital, located half in brainstem (pons), rest scattered both deep and superficially in the cortex

Answer 6

Cavernoma

Question 7

What happens in the presence of mutatnt APP, Alphabeta in affected cerebral vessels:

1. highest levels
2. reduced levels

Answer 7

1. hemorrhage
2. thrombosis

also: degradation of endothelial cells
degrades BBB through upregulation of matrix metalloproteinases (MMP)

Question 8

What are four pathological effects of cerebral amyloid angiopathy?

Answer 8

1. Small vessel ischemic disease
2. Cortical microhemorrhages (charcot buchard hemorrhages are located more centrally)
3. spontaneous lobar hemorrhages
4. superficial siderosis

Question 9

Sudden onset severe headache, stiff neck, nausea vomiting , syncope

Answer 9

Subarachnoid hemorrhage

Question 10

sudden headache, focal neurologic deficits, nausea, vomiting

Answer 10

intracranial hemorrhage

Question 11

Bilateral strokes, or large territory ischemic event with concomitant atrial fibrillation, MI, valvular disease, ventricular aneurysm

Answer 11

Cardio-embolic disease

Question 12

pure motor, pure sensory, monoplegia

Answer 12

Small vessel disease

Question 13

mixed motor, sensory, cognitive

Answer 13

Large vessel occlusive

Question 14

crossed motor/sensory deficits, cranial nerve deficits

Answer 14

brainstem