Cerebrovascular Disease

Question 1

Pathology of Cerebral Infarct

Answer 1

PMNs spare, instead macs w/in a week, will become cystic, and Wallerian degeneration in axons distant to infarct

Question 2

Big Sign of Hemorrhage

Answer 2

Displacement rather than degradation of parenchyma

Question 3

Vascular Damage in Hypertension (Location and 4)

Answer 3

Mainly in BG: arteriolarsclerosis and microaneurysms (Charcot-Bouchard, weakening of b.v.s causing them)
Subcortical infarcts - lacunar
Subcortical arteriolarsclerotic leukoencephalopathy with dementia - Binswanger’s disease (extends to white matter)

Question 4

Saccular (Berry) Aneurysms

Answer 4

Most common cerebral aneurysms, at CoW branch points. High mortality/disability/rebleeding. Bleeding covers brainstem

Question 5

Aneurysms at Branch Point

Answer 5

No media right at inside of “Y”, so dilatation forms that can burst

Question 6

2 Vascular Malformations (and how they form)

Answer 6

Arteriovenous Malformation and Hemangioma - normal transition from fetal vascular plexus to adult vasculature (artery-arteriole-capillary-venule-vein) doesn’t take place

Question 7

Cerebral Amyloid Agiopathy

Answer 7

Any protein w/ beta pleated sheet configuration. Beta amyloid protein most concerning, present sporadically in elder, in AD, and in traumatic encephalopathy. Disease of small cortical arterioles in SAH and causes multiple small infarcts

Question 8

Congo red stain

Answer 8

Reveals yellow-green dichroism with polarized light for Amyloid Beta Protein