Cerebral Structural Anormalities Flashcards
What is the definition of an aneurysm?
abnormal dilation of an artery that results from a weakening of the intima vessel layer
Where are cerebral aneurysms usually located?
base of the brain or subarachnoid space
What are risk factors to aneurysm formation?
- HTN
- smoking
- atherosclerosis
- heavy EtOH use
- congenital abnormalities
- infection
- trauma
- cocaine abuse
- fam hx
- female > 55 y/o
- AA or Hispanic
What are the types of aneurysms?
- berry (saccular)
- fusiform
- mycotic
- pseudo-aneurysm (traumatic)
What is the most common type of aneurysm?
Berry (saccular) and tend to occur at arterial bifurcations
What is the most common cause of non-traumatic subarachnoid hemorrhage?
Berry aneurysm
This type of aneurysm is formed after a traumatic injury or from the formation of atherosclerotic plaque?
fusiform
This type of aneurysm balloon or bulge out on all sides of the artery and take on bizarre shapes?
fusiform
This type of aneurysm forms d/t an infection in another part of the body that affects the wall of the artery, which then spreads to the cerebral blood vessel?
mycotic
mycotic aneurysms are most often associated with which type of infection?
subacute bacterial endocarditis
This type of aneurysm only affects the outermost layer of the artery and usually occurs from a traumatic injury (e.g. penetrating trauma)
pseudo-aneurysm
When should treatment of an aneurysm considered?
- size greater than or equal to 5 mm
- located in the posterior circulation
- prior hx of aneurysm rupture
- odd, non-smooth morphology
- changes in shape or size
What is suspected when a patient presents with the worst HA of their life?
subarachnoid hemorrhage
Intervention options for treatment for aneurysms?
- coiling
- surgical clipping
What is the treatment of choice for vasospasms?
- CCB
- Nimodipine (60mg q4h x 21 days)
What meds are used to treat vasospasms?
- CCB (nimodipine)
- milrinone (0.5 mcg/kg/min infusion x 21 days)
- mag sulfate (360 mg PO qd)
What is the dosage of nimodipine in the tx of vasospams?
60mg q4h x 21 days
What is the dosage of milrinone in treatment of vasospasm?
0.5 mcg/kg/min infusion x 21 days
What is the dosage of mag sulfate in the tx of vasospasm?
360 mg PO qd
Condition in which an excessive amount of of CSF accumulates within the cerebral ventricles?
hydrocephalus
What is the treatment of hydrocephalus?
placement of an external ventricular drain or lumbar drain
What is the most common symptom of an arteriovenous malformation?
cerebral hemorrhage and seizures
An anomalous connection between an artery and veins in the dura mater?
Dural arteriovenous fistula (DAVFs)
Benign symptoms of DAVFs?
tinnitus or visual changes
Aggressive symptoms of DAVFs?
- r/t location
- can develop gradually
- sudden HA
- seizure
- dysphagia
- parkinsonism
Management of a DAVF includes?
- endovascular embolization
- stent placement with embolization
How much CSF does the brain normally produce?
500mL/day
Types of hydrocephalus?
- communicating
- noncommunicating
- hydrocephalus ex-vacuo
- NPH
Type of hydrocephalus that occurs when the flow of CSF is obstructed after it exits the ventricles?
communicating
Type of hydrocephalus that occurs within or next to the ventricular system, preventing CSF made in the lateral and third ventricles from circulating normally?
non-communicating
What is the most prevalent type of brain tumor?
gliomas
