Cerebrovascular Disease - Krafts Flashcards
Difference between thrombosis and embolism?
Both clots are clots that can occlude vessels, but thrombosis occludes vessels where it forms, embolisms floats through vasculature and causes problems away from where it formed
What is global cerebral ischemia? Usual cause?
Lack of blood supply to the whole head
Usually caused by hypotension. Outcome will depend on severity of hypotension
In irreversible global ischemia. What are you going to see histologically?
First day: red neurons neutrophils Then: necrosis, macrophages, angiogenesis, gliosis After 2 weeks: loss of nectrotic tissue
Difference between ischemic(pale) infarcts and hemorrhagic (red) infarcts?
Ischemic (pale) infarcts:
- Usually due to thrombi
- Often arise from atherosclerotic plaques
Hemorrhagic (red) infarcts
- Usually due to emboli + reperfusion
- Often arise from heart
What is the pathology seen in this picture?
Laminar necrosis
(You can see it really well on the far right)
happens in global ischemia
What is a watershed infarct?
It is an infarct that occurs in the border areas of the major cortical arteries. Basically in the areas sort of between the ACA, MCA, and PCA.
It’s like irrigating a farm. Areas farthest away have a greater risk of going unwatered if there is a problem with pressure or water flow.
What is medically important about a TIA?
(this should be review)
They indicate that a more serious problem could occur very soon.
What is the difference of appearance between ischemic and hemorrhagic infarcts?
Look the same except that hemorrhagic have extravasated blood around
Hypertension can cause this lake-like infarct:
What is it?
Generally what does it affect?
Lacunar infarct
affects deep vessels supplying basal ganglia, deep white matter, and brainstem
What is seen in this picture?
What kind of cerebrovascular disease would cause this?
slit hemorrhage!
Caused by hypertensive cerebrovascular disease
(this ruptures small penetrating vessels)
A patient with seriously high blood pressure is brought into the ER by a husband. He says his wife began experiencing confusion, convulsions, and appears to have fallen itno a coma.
Any ideas on what it might be?
Acute Hypertensive Encephalopthy
Patient comes in with the worst headache of his life. He says he has a family history of berry anyeurism. He passes out before you can ask anything else. What is the diagnosis?
Subarachnoid hemorrhage!
What are the tiny anyeurisms that you see in parenchymal hemorrhage called?
Charcot-Bouchard microanyeurisms
(i’m not clear on if this is important or not…)
