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Neuo Block 1 > Cerebral Vascular Disease > Flashcards

Cerebral Vascular Disease Flashcards

1
Q

What kind of hemorrhage is classified with “the worst headache in my freaking life omg I’m gonna die please help”?

A

Subarachnoid

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2
Q

Reduction of brain flow rate by 60% causes what?

A

Neurons to stop generating electrical signals

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3
Q

Reduction of flow rate TO 20% for more than a few minutes resulted in what?

A

Necrosis of the involved tissue

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4
Q

What is an infarct?

A

A necrotic region of tissue

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5
Q

What is a stroke?

A

An abrupt incident of vascular insufficiency resulting in neurological function

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6
Q

Incidence of stroke increases or decreases with age? Which gender is more likely to have a stroke?

A

Increases with age

Men more likely, feminism yo

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7
Q

What are the two types of strokes?

A

Occlusive and hemorrhagic

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8
Q

What is the general difference between occlusive and hemorrhagic?

A

Occlusive: blot clot
Hemorrhagic: compromised (burst) artery

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9
Q

Is size of location more important in a stroke?

A

Location!!!!!!!!!!

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10
Q

What are some risk factors for stroke?

A
  • smoking
  • alcohol
  • obesity
  • heart disease
  • genetics
  • atrial fibrillation
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11
Q

What is a penumbra?

A

The region surrounding the area of permanent tissue damage

-area that will survive if you treat rapidly

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12
Q

Time is critical in a stroke, how much time do you have for treatment?

A

3 hours!!!!!

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13
Q

What are the two types of occlusive stroke?

A

Thrombotic and emboli

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14
Q

What is a thrombotic stroke?

A

A blood clot that forms locally over an atherosclerosis lesion
-usually has penumbras

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15
Q

What is an embolic stroke?

A

Thrombi formed not in the brain

  • thrombi detaches and travels to the brain
  • no penumbras
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16
Q

What is watershed infarct?

A

Hypoxia due to insufficient blood supply

-HYPOTENSION

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17
Q

What are the two types of hemorrhagic stroke?

A

Subarachnoid and intracerebral

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18
Q

What is a subarachnoid hemorrhage?

A

-superficial artery of the brain bursts

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19
Q

What is an intracranial hemorrhage?

A

Artery within the brain tissue bursts

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20
Q

What are common causes for subarachnoid hemorrhage?

A
  • aneurysm rupture

- arteriovenous malformation

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21
Q

What are common causes of intracerebral hemorrhage?

A
  • HYPERTENSION

- arteriovenous malformation

22
Q

What areas are likely to suffer from watershed infarct? What shape does this normally take on?

A
  • okay so arteries only supply a specific part of the brain, so the areas that are near the border of where the arteries stop are more susceptible.
  • they are wedge shaped orrrrrrr if bad enough the whole brain can suffer
23
Q

What are the advantages of the new england classifications of strokes?

A

-based on pathological features and is less complicated

24
Q

What are the advantages of the mayo clinic classifications?

A

Take clinical features into account

-takes the size of vessels into account

25
Q

Clinically, the stroke can be classified at which two things>

A
  • focal: one particular area of the brain is affected with neural deficits at multiple sites
  • diffuse: the whole brain is affected or multiple regions are affected. Patient is normally unconscious
26
Q

Pathophysiologically, stroke can be classified as what?

A
  • ischemic: reduced blood supply, decreased oxygenation of the brain tissue
  • hemorrhagic: rupture of a blood vessel
27
Q

What are the two types of hemorrhagic stroke?

A
  • in the brain parenchyma-rupture of a small artery leading to accumulation of blood and compression on adjacent tissue
  • in subarachnoid space: rupture of a superficial artery

SAME CLINICAL PRESENTATION, THE ONLY DIFFERENCE IS MECHANISM

28
Q

SEVERE HEADACHE ASSOCIATED WITH STROKE INDICATED WHAT KIND OF STROKE?

A

HEMORRHAGIC

29
Q

What is the difference between a transient ischemic attack and a stroke?

A

-deficits associated with TIA only last a few minutes to a few hours and are followed by a complete recovery

30
Q

What is responsible for transient monocular blindness?

A

-TIA caused by emboli that detach from a plaque in the internal carotid artery, enter the ophthalmic artery and render the retina temporarily ischemic

31
Q

What does TIA often precede?

A

A stroke

32
Q

Blood cells can be occluded up to what percentage and still function normally?

A

70%

33
Q

What is a paradoxical embolus?

A

Venous embolus that passes through a patent foramen oval and lodges in a cerebral artery

34
Q

What are common locations for ischemic stroke?

A
  • MCA (most common)
  • internal carotid artery
  • basilar artery
35
Q

What are the biggest concerns with ischemic stroke?

A
  • swelling of the brain!!!!!!!
  • loss of demarcation between grey and white matter
  • breakdown of myelin
  • gliosis as reaction to injury
36
Q

What are the main symptoms associated with strokes involving the MCA?

A
  • sensory loss in face and upper extremity

- speech problems-aphasia

37
Q

What is the difference in deficits between wernicke and broca

A

Wernicke: fluent, no sense speech
Broca: not fluent, makes sense speech

38
Q

Lacunae strokes: involve what artery? What symptoms?

A
  • MCA
  • pure sensory or pure motor
  • monoparesis
  • isolated sensory loss
39
Q

What are the main symptoms associated with strokes involving the ACA?

A
  • sensory and motor loss in lower extremities

- urinary incontinence

40
Q

What are the main symptoms of strokes involving the vertebral basilar system?

A
  • vertigo

- sensory loss in trunk and limbs

41
Q

What are the main symptoms of strokes involving the PCA?

A
  • gaze paralysis-CN III
  • visual field defect
  • hemianopsia: eyes deviate towards the side of a lesion to compensate
42
Q

What is an epidural hematoma?

A

Arterial bleed creates blood filled space between bone and dura mater

43
Q

What is the presentation of an epidural hematoma?

A

Short loss of consciousness, lucid interval, neurological deterioration, death

44
Q

What does the CT look like for an epidural hematoma?

A

-hematoma rarely crosses the suture line.

Lesions is lens shaped

45
Q

What is the main difference between epidural hematoma and subdural hematoma?

A

Epidural hematoma is a high pressure system and subdural hematoma is a low pressure system

46
Q

What is a subdural hematoma?

A

Rupture of bridging veins between dura and arachnoid matter

47
Q

What are the main symptoms associated with a subdural hematoma?

A
  • venous bleeding with a delayed onset of symptoms
  • brain atrophy
  • whiplash
48
Q

What is subdural hematoma usually seen in?

A

SHAKEN BABY SYNDROME
Alcoholics
Elderly

49
Q

What are the causes of subarachnoid hemorrhage?

A
  • ruptured berry aneurysm
  • marfans
  • trauma
  • congenital arteriovenous malformation
50
Q

What kind of hemorrhage causes yellow CSF?

A

Subarachnoid hemorrhage

Neuo Block 1 (10 decks)

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