Cerebrovascular disease

Question 1

What are the different types of glial cells?

Answer 1

Astrocytes
Oligodendrocytes
Ependymal cells

Question 2

What do astrocytes do?

Answer 2

Supportive cell & play a role in CNS metabolism and reaction to injury

Question 3

What do oligodendrocytes do?

Answer 3

Form myelin sheaths around axons of CNS

Question 4

What do ependymal cells do?

Answer 4

Line the ventricular system

Question 5

What do microglia do?

Answer 5

Function as macrophage of CNS

Question 6

What is a red neuron a sign of?

Answer 6

Lethal injury to neuron as a result of ischaemia/hypoxia (e.g. stroke)

Question 7

What do neurons appear like under a microscope in the context of an axonal injury

Answer 7

Cell body swelling & large nucleus

Question 8

What are oligodendrocytes particularly sensitive to?

Answer 8

Hypoxic injury (e.g. stoke)

Question 9

How to astrocytes appear under microscope?

Answer 9

Star shapes cells

Question 10

What is gliosis?

Answer 10

Scarring process completed by astrocytes that is a sign for CNS injury

Question 11

What can come as a result of ependymal cell tumour formation?

Answer 11

Obstruction of CSF flow

Question 12

What are M1 microglia responsible for?

Answer 12

Chronic response to injury - Pro-inflammatory

Question 13

What are M2 microglia responsible for?

Answer 13

Acute response to injury - Anti-inflammatory, Phagocytic

Question 14

Which of the following forms of oedema involve breaking of the blood brain barrier: Ionic Oedema or Vasogenic Oedema?

Answer 14

Vasogenic Oedema

Ionic Oedema is due to a chemical gradient and therefore there is no physical breaking of the blood brain barrier

Question 15

What is cerebrovascular Disease?

Answer 15

Brain problems caused by fucked up blood vessels

Question 16

What are some causes of global hypoxic ischaemia?

Answer 16

Cardiac arrest
Hypovolaemic shock

Question 17

What typically causes focal hypoxic ischaemia?

Answer 17

Vascular obstruction

Question 18

How low does MAP have to drop below so that autoregulatory mechanisms cannot compensate for cerebral bloodflow?

Answer 18

50mmHg

Question 19

Are embolic or haemorrhagic strokes more common?

Answer 19

Embolic

Question 20

What causes cerebral infarction?

Answer 20

Thromboembolic events

Question 21

How does carotid artery disease present?

Answer 21

• Contra-lateral weakness or sensory loss
• If dominant hemisphere may lead to aphasia or apraxia

Question 22

How will a lesion in the middle cerebral artery present?

Answer 22

Weakness predominantly in the contralateral face & arm

Question 23

How will a lesion in the anterior cerebral artery present?

Answer 23

Weakness & sensory loss in contralateral leg

Question 24

How will vertebro-basilar artery disease present?

Answer 24

• Vertigo
• Ataxia
• Dysarthria
• Dysphasia

Question 25

What are lacunar infarcts?

Answer 25

Small infarcts due to the occlusion of small penetrating vessels. These mainly effect the basal ganglia

Question 26

What can multiple lacunar infarcts lead to?

Answer 26

Multi-infarct dementia

Question 27

What are some key pathological findings that are characteristic of hypertensive encephalopathy?

Answer 27

- Global cerebral oedema - Tentorial & tonsillar herniation - Arteriolar fibrinoid necrosis - Petechiae

Question 28

Where do intracerebral haemorrhages most commonly occur?

Answer 28

Basal ganglia Thalamus

Question 29

What is the most common cause of cerebral haemmorhage?

Answer 29

Arterio-venous malformations

Question 30

What is the most common spontaneous cause of subarachnoid haemorrhage?

Answer 30

Rupture of a saccular (berry) aneurysm

Question 31

How do subarachnoid haemorrhages present?

Answer 31

- Abrupt onset - Severe headache - Vomiting - Loss of consciousness - Bloody CSF