Cerebral Vasculature and Cerebrovascular Disorders

Question 1

Describe the blood supply to the brain

Answer 1

1. Vertebral artery

2. (Common Carotid -> ) Internal Carotid artery

Question 2

Describe the venous drainage of the brain

Answer 2

Cerebral veins -> venous sinuses in the dura mater -> internal jugular vein

Question 3

What are the types of haemorrhage?

Answer 3

1. Extradural
2. Subdural
3. Subarachnoid
4. Intracerebral

Question 4

What haemorrhage is trauma, immediate clinical effects (arterial, high pressure)?

Answer 4

Extradural

Question 5

What is an extradural haemorrhage?

Answer 5

Trauma, immediate clinical effects (arterial,

high pressure)

Question 6

What haemorrhage is trauma, can be delayed clinical effects (venous, lower pressure)?

Answer 6

Subdural

Question 7

What is a subdural haemorrhage?

Answer 7

Trauma, can be delayed clinical effects

venous, lower pressure

Question 8

What haemorrhage is ruptured aneurysms?

Answer 8

Subarachnoid

Question 9

What is a subarachnoid haemorrhage?

Answer 9

Ruptured aneurysms

Question 10

What haemorrhage is spontaneous hypertensive?

Answer 10

Intracerebral

Question 11

What is an intracerebral haemorrhage?

Answer 11

Spontaneous hypertensive

Question 12

Which haemorrhages are from trauma?

Answer 12

1. Extradural

2. Subdural

Question 13

Which haemorrhage has immediate clinical effetcs?

Answer 13

Extradural

Question 14

Which haemorrhage can be delayed clinical effects?

Answer 14

Subdural

Question 15

What is the name for a stroke?

Answer 15

CVA - Cerebrovascular Accident

Question 16

What is a CVA - Cerebrovascular Accident?

Answer 16

A stroke

Question 17

What is the definition of a stroke?

Answer 17

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

Question 18

What are the two causes of a stroke?

Answer 18

1. Thrombo-embolic

2. Haemorrhage

Question 19

What is the most common cause of a stroke?

Answer 19

Thrombo-embolic (85%)

Question 20

If a stroke is rapid onset, what is the likely origin?

Answer 20

Vascular

Question 21

What is a TIA - transient ischaemia attack?

Answer 21

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

Question 22

What is the different in a CVA and TIA?

Answer 22

CVA - >24hrs duration

TIA - resolves completely within 24hrs

Question 23

What is an infarction?

Answer 23

Degenerative changes which occur in tissue following occlusion of an artery

Question 24

What is a cerebral ischaemia?

Answer 24

Lack of sufficient blood supply to nervous tissue resulting in permanent damage if blood flow if not restored quickly

Question 25

What is thrombosis?

Answer 25

Formation of a blood clot (thrombus)

Question 26

What is embolism?

Answer 26

Plugging of small vessel by material carried from larger vessel e.g. thrombi from the heart or atherosclerotic debris from the internal carotid

Question 27

What are risk factors for stroke?

Answer 27

1. Age 2. Hypertension 3. Cardiac disease 4. Smoking 5. Diabetes mellitus

Question 28

What are the symptoms of an anterior cerebral artery stroke?

Answer 28

1. Paralysis of contralateral structures (leg > arm, face) 2. Disturbance of intellect, executive function and judgement (abulia) 3. Loss of appropriate social behaviour

Question 29

What are the symptoms of an middle cerebral artery stroke?

Answer 29

``` “Classic stroke” 1, Contralateral hemiplegia: arm > leg 2. Contralateral hemisensory deficits 3. Hemianopia 4. Aphasia (L sided lesion) ```

Question 30

What are the symptoms of an posterior cerebral artery stroke?

Answer 30

Visual deficits 1. Homonymous hemianopia 2. Visual agnosia

Question 31

When will aphasia occur in a middle cerebral artery stroke?

Answer 31

L sided leison

Question 32

What cerebral artery stroke affects legs?

Answer 32

Anterior cerebral stroke

Question 33

What cerebral artery stroke affects arms (and face)?

Answer 33

Middle cerebral stroke