Cerebrovasclar Disorders Flashcards

1
Q

What is a cerebrovascular disorder?

A

Damage (block/break) to blood vessels resulting from an underlying vascular disease

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2
Q

Why are CVDs the 3rd most common cause of death in developed countries?

A

CVD is very affected by lifestyle and environmental factors (e.g. high blood pressure - stress/cholesterol)

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3
Q

What does the brain need an uninterrupted supply of? Why?

A

O2 and glucose via the blood

The brain has no reservoir; needs >20% of entire O2 for normal functioning (children need up to 50%)

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4
Q

The term for cholesterol?

A

Hyperlipidermia

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5
Q

What are risk factors for CVD that you can’t control?

A
Age (older = higher risk due to normal deterioration)
Family history (hx of strokes)
Gender (more likely in men)
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6
Q

Risk factors for CVD you can control?

A
Hypertension
Cholesterol
Smoking
Overweight
Poor diet + no exercise
Excessive alcohol (ETOH)
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7
Q

Medical conditions which are risk factors for CVD?

A

Heart disease (atrial fibrillation - irreg <3beat)
IHD - ischemic <3 disease
Diabetes
TIA - transient ischemic attack

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8
Q

What is a precursor to having a stroke (warning sign)?

A

TIA

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9
Q

Anoxia and Hypoxia?

A

Anoxia: total deprivation of O2
Unconscious/dead

Hypoxia: reduced supply of O2
Impaired concentration, STM, new learning & judgement
*Sleep apnoea, chronic obstructive pulmonary disease

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10
Q

Lesion:

A

Discontinuity of brain tissue (almost always loss in fx)

  • darker/lighter area (depending on scan)
  • demyelination may look similar to lesion on scan
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11
Q

Ischemia:

A

Inadequate blood supply

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12
Q

Infarct:

A

Area of dead cells caused by ischemia

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13
Q

Are ischemia and hypoxia the same?

A
Hypoxia = referring to event (resulting in either semi-perm or permanent cell death)
Ischemia = also inadequate blood supply, but in other contexts too (can refer to both hypoxia and anoxia)
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14
Q

Necrosis

A

Irreversible neuronal cell death
4-6 anoxia
Severe hypoxia (possibility)
8-10 non-severe hypoxia (possibility)

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15
Q

How can blood supply be impaired?

A

Anoxia & hypoxia
Increase ICP suddenly
Blood spilling out of blood vessel (toxins interfere w/ brain metabolism)

Area of brain blood vessel supplies dictates symptoms

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16
Q

2 types of hydrocephalus?

A
  1. Communicating: blood mixes with CSF & interferes with reabsorption
  2. Obstructive: blocked CSF circulation
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17
Q

What causes obstructive hydrocephalus?

A

Kids - stenosis (artery narrowing)

Adults - tumors infiltrating ventricles

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18
Q

Breakdown of CVAs:

A

TIA - collectively called ischemia: short-lasting insufficient blood supply (no necrosis)
Infarction - severer loss of blood flow (necrosis)
Haemorrhage - bleeding & displacement of brain (more severe - permanent damage/death)

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19
Q

Infarcts?

A

Thrombosis

Embolism

20
Q

Haemorrhages

A

Intracerebral
Subdural
Aneurysm
AVM

21
Q

Critical distinction between ischemic/haemorrhagic:

A

Ischemic: blood thinner breaks down clots = blood supply restored
Haemorrhagic: blood thinner = death

22
Q

Symptoms of TIAs:

A

Motor, sensory or cognitive signs (sudden onset):

  • unilateral weakness/tingling in face/limbs
  • disorientation
  • normal cog. functioning loss (language, visual disturbance)
  • normal motor functioning (weakness,slurred speech)
23
Q

Symptoms of anterior TIA?

A

Brief clumsiness or limb weakness, dysarthria (muscles used for speech are weak = slowed/slurred speech), aphasia

24
Q

Symptoms of posterior TIA?

A

Dizziness, neglect, double vision, numbness or weakness of extremities

25
Q

Most common cerebral infarction?

A

Unilateral MCA

26
Q

Blockage of cerebral circulation:

A

Level of <3: entire brain
Carotid artery: anterior & middle cerebral circulation
Vertebral artery: posterior circulation

27
Q

Coronary thrombosis?

A

Heart attack

28
Q

Cerebral thrombosis?

A

Stroke

29
Q

Lacunar infarction

A

Due to blockage of very small vessels
Deep in brain = usually pure motor & sensory deficits
Risk-factors: hypertension & diabetes

30
Q

What is the most common neuropathological process?

A

Atherosclerosis

  • build up of fat on artery walls
  • worse at bifurcation of arteries (common carotid)
31
Q

Thrombosis: why do clots form?

A

Deviation from normal platelet action

32
Q

Antithrombotic agent?

A

Asprin

33
Q

Common cause of haemorrhagic CVA?

A

Rupturing of aneurysm

34
Q

Usually anterior of brain involved:

A

Embolism

Haemorrhage

35
Q

2 types of haemorrhages

A

Intracerebral: localized to L/R (defective artery bursts)
Subarachnoid: diffuse effects (caused by hypertension/defective blood vessels)

36
Q

Where do about 1/2 aneurysms take place?

A

Middle carotid artery

37
Q

AVM

A

Arteriovenous Malformation
tangle of abnormal blood vessels, communication between arteries and veins effected therefore abnormal blood flow
-headache + vague cognitive complaints
-more serious: slow bleeding

38
Q

General Ischemic CVA

A
Feeling strange + collapse with unilateral weakness
No H,N,V
Focal neurological signs
No ICP 
Tx: blood thinner
39
Q

General Haemorrhagic CVA

A
While awake
H,N,V
Global neurological signs
Papilledema (raised ICP)
Blood thinners = death
40
Q

Left hemisphere

A

Language & symbolic processing

- Broca’s area, Wernicke’s area, connections between them

41
Q

Right hemisphere

A

Visuospatial abilities
Rhythmic processing
Non-verbal processing

42
Q

Frontal cortex

A

Motor strip
Executive deficits
Personality change
Emotional change

43
Q

Parietal region

A

Calculations
Symbolic gestures/actions
Left/right disorientation

44
Q

Occipital cortex

A

Visual processing

Object recognition

45
Q

Deep temporal

A

Episodic memory

Verbal/semantic memory

46
Q

Angiograpgy

A

Diagnosis of aneurysms, AVMs, artery occlusion, stenosis