Cerebral Vasculature

Question 1

What 3 main vessels supply blood to the brain?

Answer 1

Vertebral artery
Common carotid artery
Internal carotid

Question 2

Describe the venous drainage of the brain

Answer 2

Blood starts in the cerebral veins
Drains into dural venous sinuses
Eventually ends up in the internal jugular vein

Question 3

What are the 4 types of haemorrhage? Describe where the bleed is for each

Answer 3

Extradural- above the dura mater, underneath the skull
Subdural- between the dura and arachnoid mater
Subarachnoid- between the arachnoid and pia mater
Intracerebral- inside the brain a blood vessel ruptures

Question 4

What are the 4 types of haemorrhage? Describe how each is caused

Answer 4

Extradural- trauma, has immediate clinical effects (arterial and high pressure)
Subdural- trauma, can have delayed clinical effects (venous and low pressure)
Subarachnoid- ruptured aneurysm
Intracerebral- spontaneous hyeprtensive

Question 5

What are the 2 causes of stroke and how common are they?

Answer 5

Thrombo embolic (85%)
Haemorrhage (15 %)

Question 6

Define transient ischaemic attack

Answer 6

Rapidly developing focal disturbance of brain function of presumed vascular origin that resolves completely within 24 hours

Question 7

Define infarction

Answer 7

Degenerative changes that arise due to occlusion of an artery

Question 8

Define cerebral ischaemia

Answer 8

Lack of blood flow to cerebral tissue that results in permanent damage if blood supply is not quickly restored

Question 9

Define thrombosis

Answer 9

Formation of a blood clot

Question 10

Define embolism

Answer 10

Occlusion of a small vessel via material carried from a large vessel

Question 11

What is the acronym for identifying a stroke and what does it stand for?

Answer 11

FAST

Face- one side may droop
Arms- can’t lift both and keep them up
Speech- cant speak, speech slurred or garbled
Time- time to call 999

Question 12

What are risk factors for stroke?

Answer 12

Age
Hypertension
Cardiac disease
Smoking
Diabetes mellitus

Question 13

What artery supplies the superior anterior surface of the brain?

Answer 13

Anterior cerebral artery

Question 14

What artery supplies the lateral surfaces of the brain?

Answer 14

Middle cerebral artery

Question 15

What artery supplies the posterior inferior surface of the brain?

Answer 15

Posterior cerebral artery

Question 16

What are the names of the 3 cerebral arteries that supply the surface of the brain?

Answer 16

Anterior, middle and posterior

Question 17

What are symptoms of stroke originating in the anterior cerebral artery?

Answer 17

Paralysis of contralateral structures (mainly legs)
Disturbance of intellect, executive functions and judgement
Loss of social behaviour

Question 18

What are symptoms of stroke originating in the middle cerebral artery?

Answer 18

Classic stroke
Contralateral hemiplegia (more arm than leg)
Contralateral hemisensory deficits
Hemianopia (loss of one vision on one side of visual field)
Aphasia (unable to produce speech)

Question 19

What are the 5 main sinuses?

Answer 19

Superior sagittal
Straight
Confluence 
Transverse
Sigmoid

Question 20

What is the definition of stroke?

Answer 20

Rapidly developing focal disturbance of brain function of presumed vascular origin and of >24 hours duration

Question 21

What type of stroke is arterial? How does it clinically present?

Answer 21

Extradural, presents acutely

Question 22

What type of stroke is venous? How does it clinically present?

Answer 22

Subdural, presents delayed

Question 23

What type of stroke is hypertensive?

Answer 23

Intracerebral/parenchymal