cerebrovascular testing Flashcards
what is the main mech. of disease in crebrovascular symptoms
atheromatous plaque formed within the arterial wall
embolius
- name the different types of plaque
fatty streak - thin lipid layer in intma
fibrous - accumulation of lipids
complicated lesion- cellular debris within lesion
ulcerative lesion - fibrous cap deteriorates -
emboli
intra-plaque hemorrhage - described as sonolucent core- caused by hemmorhage of vasa vasorum which bleeds into plaque
mech of disease in cerebrovascular system
atherosclerotic cond’
atherosclerosis
thromboembolic
aneurysm
what is aneurysm
localized dilitation of a blood vessel due to congenital defects or wall weakness
>1.5 x adjacent segment of vessel
describe FMD
fibromuscular dysplasia
diffuse dysplacia mid/distal ICA
young women
bead-like appearance
describe CBT
carotid body tumor
small structure splaying carotid bifurcation
highly vascular
tx with ligation of feeding vessels - from ECA
describe neointimal hyperplasia
intimal thickening
response to injury/ reconstruction
stenosis may occur 6-24 mo (endarterectomy )
palpable pulse in crebrovascular
CCA, Superficial temporal, subclavian, axillary
what do you HEAR with auscultation
B%ruit
noise heard with turbulant flow
but may not be heard with very tight stenosis >90%
what should be done with subclav a bruie
bilateral pressures
to detect prox stenosis /// subclavian steal
Anterior circulation symptoms typically have what characteristic
lateralizing neurological deficits
left side of brain controls right side of body and visa versa
specific eye sx (amaurosis fugax ) suggest lesion where
ipsilateral ICA disease
sx with ICA lesion :
5
unilateral paresis (weakness) unilateral paresthesia (tingling) aphasia (inability to speak) amaurosis fugax (temporaty loss of vision)
myopia is what and is it consistent with ICA lesion
nearsightedness
NOT consistent with ICA lesion
homonymous hemianopia is what
defective vision in left and right halves of the visual fields
not alway related to ICA lesion
symptoms MCA lesion
3
aphasia/ dysphasia
severe FACIAL arm hemiparesis or hemiplega (rather than leg)
behavioral changes
symptoms w ACA lesion
more severe leg hemiparesis / hemiplegia
incontinence
loss of coordination
Posterior circulation (vertebrobasilar lesions symptoms
vertigo (equilibrium) ataxia - (uncontrolled gait) bilateral visual blurring (double vision--diplopia) bilateral paresthesia anesthesia drop attack:
sx with PCA lesions
dyslexia
coma
paralysis does NOT occur
general non-localizing symptoms
dizziness
syncome
severe headache
