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Neurology > Cerebrovascular Disease > Flashcards

Cerebrovascular Disease Flashcards

1
Q

What does cerebrovascular disease mean

A

Any abnormality of the rain caused by a pathologic process of blood vessels
Leads to brain injury due to altered blood flow

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2
Q

Which is the most common acute and dramatic manifestation of cerebrovascular disease

A

Cerebrovascular accident or stroke

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3
Q

Third leading cause of death in the US

A

Cerebrovascular accident

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4
Q

Is cerebrovascular accident common in Ghana

A

Yes

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5
Q

Which blood vessels are affected in cerebrovascular disease

A

Intracranial vessels (Anterior cerebral artery, middle cerebral artery, basilar artery or posterior cerebral artery)

extracranial vessels(Carotid artery with common carotid artery And internal carotid artery, vertebral artery ,others)

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6
Q

What is transient ischemic attack

A

Fully reversible neurological deficits lasting no more than a few minutes but occasionally up to 24 hours

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7
Q

Is there brain damage in transient ischemic attack

A

no structural brain damage

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8
Q

Risk factors to transient ischemic attack

A

atherosclerosis with superimposed hypotension or spasm of the disease vessel

Other extracranial vascular disease like embolism

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9
Q

What is stroke or cerebrovascular accident

A

Rapid onset of focal disturbance of cerebral function which has a vascular origin and of more than 24 hours duration

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10
Q

Is there a permanent brain damage in cerebrovascular accident

A

Yes

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11
Q

Factors affecting tissue survival in CNS ischemia

A 
Collateral circulation 
Ischemia duration
Systemic circulation state 
Hypoxia
Thrombus propagation
Micro circulatory bed resistance 
Micro circulatory bed  hypertension 
Micro circulatory bed hyper viscosity

Micro circulatory bed diffuse thrombus
Edema
Raised icp

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12
Q

Most sensitive cells in the brain to ischemia

A

Neuron (the most )

Oligodendrocytes
AStrocytes
Microglia
Blood vessels

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13
Q

What happens in mild hypoxia

A

Selective neuronal necrosis

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14
Q

What happens in moderate hypoxia

A

Neuronal necrosis
Neuroglia necrosis
Blood vessels and Microglia spared

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15
Q

Underlying cause of infarction stroke

A

Thrombotic

Common association with atherosclerosis and plaques rupture leading to stenosis , propagation and embolization

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16
Q

Disease associated with infarction stroke

A

DM

Hypertension

17
Q

CNS infarction due to thrombosis causes

A

Non infectious causes - pregnancy, puerperium, OCCs, hematological disroders, extreme dehydration

Infectious causes- immunosupression leading to infections, sinus infections, ear infections Compound fracture with Septic infarction

Drug abuse

Heroin
Amphetamines

18
Q

Why are most emboli in the CNS hemorrhagic

A

Necrosis of vessel wall
Lysis of embolus with restoration of some blood flow
Reperfusion of embolus

19
Q

Source of embolism in CNS

A 
Cardia mural
Carotid artery
Paradoxical 
Fat emboli 
Marrow emboli
Air emboli
20
Q

Which are of brain is most vulnerable to emboli blockage

A

Middle cerebral artery

21
Q

Sequence of events of vascular occlusion in CNS

A

Necrosis of neurons, neuroglia, Microglia, blood vessels,
4-6h -> coagulative necrosis
12-15h -> sharp demarcation
24h - reactive changes with inflammation and proliferation of Microglia, AStrocytes and capillaries
Several months- shrunken cystic lesion , glial fibrils, small blood vessels

22
Q

Consequence of vertebra basillar occlusion

A

Infarction of brainstem, cerebellum, posterior cerebral arterial territory

23
Q

Second name of CNS hemorrhage

A

Hemorrhagic stroke

24
Q

Bleeding sites in CNS hemorrhage

A

Brain
Spinal cord substance
Subarachnoid space
Mixed

25
Q

Major Risk factors to CNS hemorrhage

A

Hypertension
Congenital anomalies
Vascular malformations

26
Q

Minor Risk factors to CNS hemorrhage

A

Vasculitis
Bleeding diarheses
Tumours

27
Q

Primary intraparenchymal hemorrhage predisposing changes

A

Fibrinoid necrosis
Hyaline arteriosclerosis
Microaneurysm - Charcot Bouchard

28
Q

Size oh hemorrhage in primary intraparenchymal

A

Massive more than 3 cm in cerebral hemispheres

Less than 1.5 cm in brainstem

29
Q

Brain common site of spontaneous hemorrhage

A

Basal ganglia , pons, cerebellum

30
Q

Subarachnoid hemorrhage main causes

A

65% saccular berry aneurysm
5% a-v cavernous malformations
20% no cause found
10% others

31
Q

saccular berry aneurysm more common for male or female

A

Female

32
Q

Secondary effects of subarachnoid hemorrhage

A

Rebleeding

Vasoconstriction

Neurology (31 decks)

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