Cerebrovascular Disease/Stroke Flashcards
Vulnerable neurons in ischemic/hypoxic encephalopathy (2)
Hippocampus
Purkinje cells in cerebellum
Non-hemorrhagic infarcts are usually due to ___
thrombus –> stable
Hemorrhagic infarcts are usually due to ___
embolus –> breaks up –> reprofusion
Which of the following does NOT present in acute cerebral infarction?
A. Red nuerons
B. Spheroid bodies
C. Vascular proliferation at border b/w necrotic and viable tissue
D. Intense neutrophilic response
D. Neutrophils will melt neurons
A. Coagulation necrosis
B. Axonal degeneration
Subacute cerebral infarct present with (2)
- Foamy macrophages: full of lipids of necrotic neurons
* Reactive gliosis (gemistocytes): proliferation of astrocytes that participate as part of response to injury
Remote cerebral infarct present with (2)
Cyst formation
Glial scarring
T/F: Premature infants with perinatal asphyxia present with periventricular leukomalacia and multicystic encephalopathy.
False: Term infants present this way.
Periventricular leukomalacia = meltdown of white matter adjacent to ventricles
Premature infants present with germinal matrix hemorrhage that causes intraventricular hemorrhage.
Most common sites of hypertensive hemorrhage
Basal ganglia-thalamus
Pons
Cerebellum
Saccular Aneurysm arise where?
At branch points
o Anterior cerebral artery/anterior communicating artery
o Trifurcation of middle cerebral artery
o Internal carotids/posterior communicating arteries
o Posterior circulation: basilar arteries/vertebral arteries
T/F: Amyloid angiopathy hemorrhage involves deep gray structures.
False. Involves primarily white matter, spares adjacent deep gray structure.
Vs. spontaneous hypertensive hemorrhage
T/F: Ischemic strokes mostly involve arterials.
True: 80% arterials
T/F: Hemorrhagic stroke loses 2 million neurons/minute
False. Ischemic stroke
Causes of atherothrombotic ischemic stroke is occurs in which vessels? (3)
Internal carotids
Vertebrals
Basilar artery
Causes of lacunar ischemic stroke is occurs in which vessels? (4)
Perforating arteries of ACA, MCA, PCA, basilar vertebral arteries
Most common cardiac condition that causes cardioembolism?
Arterial fibrillation
Name the artery responsible for the following symptoms in the ischemic stroke?
o Behavior change
o Leg weakness
Anterior cerebral artery (ACA)
Frontal lobe
Name the artery responsible for the following symptoms in the ischemic stroke?
o Lack of awareness of problem = anosognosia
Right medial cerebral artery
Posterior frontal lobe, parietal lobe, temporal lobe
Name the artery responsible for the following symptoms in the ischemic stroke?
Left gaze deviation
Left medial cerebral artery
Posterior frontal lobe, parietal lobe, temporal lobe
Name the artery responsible for the following symptoms in the ischemic stroke?
o Left neglect
o Left sided weakness
Right medial cerebral artery
Posterior frontal lobe, parietal lobe, temporal lobe
Name the artery responsible for the following symptoms in the ischemic stroke?Quadrantanopsia or hemianopsia
Both right and left medial cerebral artery
Name the artery responsible for the following symptoms in the ischemic stroke?
Aphasia
Left medial cerebral artery
Name the artery responsible for the following symptoms in the ischemic stroke?
Right gaze deviation
Right medial cerebral artery
Posterior frontal lobe, parietal lobe, temporal lobe
Name the artery responsible for the following symptoms in the ischemic stroke?
Hemi-visual field loss = homonymous hemianopsia
Posterior cerebral artery
Occipital lobe
Name the artery responsible for the following symptoms in the ischemic stroke?
Lateral medulla syndrome:
Hemiataxia (incoordination)
Vertigo from nystagmus
Ipsilateral facial, contralateral body symptoms
Vertebral artery
Name the artery responsible for the following symptoms in the ischemic stroke?
Medial medulla: Locked-In Syndrome
Anterior spinal artery
Name the artery responsible for the following symptoms in the ischemic stroke?
Unilateral incoordination
Posterior Inferior Cerebellar Artery (PICA)
Name the artery responsible for the following symptoms in the ischemic stroke?
Coma or locked-in syndrome
Basilar artery
Pons, midbrain
Name the arteries (2) responsible for the following symptoms in the ischemic stroke?
Unilateral incoordination/vertigo (nystagmus)
Anterior inferior cerebellar artery (AICA)
Superior cerebellar artery (SCA)
Wallenberg syndrome presents with all the following EXCEPT: A. Vertigo B. Contralateral facial numbness C. Ipsilateral incoordination D. Ipsilateral Horner's E. Contralateral body numbness
B. Ipsilateral facial numbness
Pure motor weakness is caused by which vessels (2)?
Lenticulostriates: MCA perforates (Posterior limb internal capsule) Basilar perforates (Pons)
Pure sensory weakness is caused by what vessel?
Thalamogeniculates: PCA perforators (Lateral thalamus)
Which of the following is TRUE of hemorrhagic stroke symptoms? A. Contralateral weakness B. Contralateral loss of vision C. Headache D. No impairment of consciousness
C
A. Ipsilateral weakness
B. Ipsilateral loss of vision
D. Reduced consciousness –> coma
Cause of subarachnoid hemorrhagic stroke?
Aneurysm rupture
Cause of intraventricular hemorrhagic stroke?
Vessel malformation
Cause of intraparenchymal hemorrhagic stroke?
Hypertension
Vessel malformation
Coagulopathies
Infection/tumor/drugs
Pinpoint pupils suggests ____
Pontine hemorrhage
Vertigo suggests ____ hemorrhage
cerebellar
