CH 14--Nervous System 3/Vascular Disorders Flashcards
4 TYPES OF Intracranial Hemorrhage
Etiology: - Trauma - Rupture of blood vessels (e.g. congenital abnormality, hypertension) - Coagulation defects
4 Types:
- Epidural hematoma
- Subdural hematoma
- Subarachnoid hemorrhage
- Cerebral hemorrhage
KNOW THE FOUR. COMING UP!
4 TYPES OF Intracranial Hemorrhage
- _________Hematoma
- RUPTURE of a meningeal artery (most common the MIDDLE meningeal artery) usually due to a fracture of temporal bone
- Located between skull & dura = increased intrcranial pressure + tentorial herniation
EPIDURAL
4 TYPES OF Intracranial Hemorrhage
- ____________ Hematoma
- A collection of blood between the dura & arachnoid
- RUPTURE of _______ _________passing from cerebral
cortex to superior sagittal sinus - Occurs most frequently:
- over convexity of hemispheres,
- in older persons
- Unilateral or bilateral
3 SUBDURAL HEMATOMA Types:
1. Acute: due to ________
- usually assosciated with: brain laceration cerebral edemaraised ICP
- 80% mortality
2. Subacute: usually manifested within 10 days after
trauma.
3. Chronic: due to brain atrophy
. slow bleeding»>clot formation»>central part of clot disintegrates»»»>osmotic effect (imbibes fluid)»>expands slowly, COMPRESSING THE BRAIN»»»»
—convulsions
—paralysis
—-atrophy = dementia
SUBDURAL
bridging veins
trauma
4 TYPES OF Intracranial Hemorrhage
- _________________ Hemorrhage
- RUPTURE OF BERRY ANEURYSMS in circle of Willis
- Caused by _______ _________of media → bulging of
arterial wall into small saccular aneurysms (4-7 mm) - Hypertension, atherosclerosis & exercise predispose
to rupture → fatal hemorrhage in 30-50% of cases - Large intact aneurysm → focal symptoms (e.g.
headache, 3rd nerve palsy)
**Multiple aneurysms are seen in about 20-30% of cases of berry aneurysm.Such aneurysms are”congenital” in the sense that the defect in the arterial wall is present from birth, but the actual aneurysm takes years to
develop, so that rupture is most likely to occur in young to middle age adults
.
SUBARACHNOID
congenital defect
Cerebral
4 TYPES OF Intracranial
- ____________ Hemorrhage 4 OF 4
Etiology: Most commonly by hypertension Site: 1. Cerebral (65%) 2. Pontine 3. Cerebellar
Cerebral
3 TYPE OF Cerebral Hemorrhage
- Cerebral (____%)
- Rupture of _______– ___________ aneurysms at the
bifurcation of small intra-parenchymal arteries due
to sudden ↑ in blood pressure
- Hematoma destroys brain tissue around basal ganglia
and internal capsule»»»Hemiplegia (pyramidal tract) =
Rapid increase of intracranial pressure = tentorial herniation (40% mortality)
65%
Charcot-Bouchard
3 TYPE OF Cerebral Hemorrhage
- Pontine:
= quadriplegia, coma, pin-point pupils
KNOW
3 TYPE OF Cerebral Hemorrhage
- Cerebellar: = loss of balance, severe occipital headache,vomiting
KNOW
_________ __________—70-80% of all strokes, 7th decade of life, more in males
Etiology:
1. Atherosclerosis (carotid, basilar) → thrombosis
- Embolism:
a. myocardial infarction → detached mural thrombus
b. cardiac arrhythmias → auricular fibrillation
c. bacterial endocarditis → detached vegatation
d. atherosclerosis of aortic arch, carotid or circle of willis
Manifestation:
- Onset: acute, but more gradual than with hemorrhage
- Progressive loss of neurological functions depending on site (side of body opposite to infarct)
- Raised ICP due to edema
Treatment:
- Supportive
- Corticosteroids & diuretics: decrease ICP & edema → clinical improvement
- Physical therapy
Cerebral Infarction
Transient Ischemic Attacks (TIA)
— Caused by small _______ (atherosclerosis of carotid,
aorta)
— Emboli disintegrate → rapid recovery within 24 hours
emboli
Hypertensive Encephalopathy
Temporary arterial spasm in hypertensive patients:
a. Ischemia: transient neurological dysfunction,
convulsions
b. Edema: raised ICP
**Needs immediate treatment to reduce
blood pressure & _______ ____________!!
cerebral edema
