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x Neurology 200 > Chapter 14: Vascular Disease > Flashcards

Chapter 14: Vascular Disease Flashcards

1
Q

Anterior (carotid) circulation supplies….

A

Cerebral hemispheres except for the medial temporal lobes and a portion of the occipital lobes.

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2
Q

Posterior (vertebro-basilar) circulation supplies…

A

The brainstem, thalami, cerebellum, and the posterior portions of the cerebral hemisphere

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3
Q

Know the anterior and posterior circulations

A

!!!

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4
Q

Percent of ischemic vs. hemorrhagic strokes

A

80% ischemic, 10% subarachnoid and intracerebral hemorrhages each

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5
Q

Different types of ischemic strokes

A

Thrombotic, embolic, and systemic hypoperfusion mechanisms

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6
Q

Thrombotic strokes

A

Large vessels for atherosclerotic

Smaller, penetrating intracranial arteries caused by HTN

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7
Q

Embolisms come mostly from…

A

The heart. Also from the aorta, ICAs, and VAs, and from systemic veins

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8
Q

Systemic Hypoperfusion from…

A

MI or arrhythmia and systemic hypotension from hypovolemia. Think about watershed strokes for this one.

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9
Q

Left Cerebral Hemisphere Strokes signs…

A

Motor: Right hemiparesis (arm,hand,face>leg)
Sensory: Right hemisensory loss
Cognitive: Aphasia

Deep or large lesions: conjugate deviation of the eyes to the left; right hemianopia or hemi-inattention

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10
Q

ICA occlusive disease leads to…

A

Transient monocular visual loss along with the other signs of cerebral hemisphere strokes

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11
Q

Right Cerebral Hemisphere Strokes signs…

A

Motor: Left hemiparesis (arm,hand,face>leg)
Sensory: Left hemisensory loss
Cognitive: Poor drawing, copying, neglect of left visual field

Deep or large lesions: conjugate deviation of the eyes to the right; left hemianopia

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12
Q

Lateral medulla stroke signs

A

Sensory: Ipsilateral facial pain, or reduced pain and temperature sensation on the ipsilateral face, or both;
Loss of pain and temperature in the contralateral limbs and body; Ipsilateral Horner syndrome
Motor: Nystagmus; incoordination of the ipsilateral arm; leaning and veering while sitting or walking with gait ataxia

Deep lesions: Dysphagia and hoarseness

Cause: intracranial VA occlusion

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13
Q

Bilateral pontine base and often medial tegmentum stroke signs

A

Motor: Quadriparesis; unilateral or bilateral conjugate gaze paresis; sometimes internuclear ophthalmoplegia or VIth nerve palsy
Cognitive: Coma if medial tegmentum involved bilaterally

Cause: Basilar artery occlusion, pontine hemorrhage

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14
Q

Cerebellar infarction signs

A

Motor: Gait ataxia (can’t walk); dysarthria; ipsilateral arm dysmetria

Cause: embolism of PICA or SCA or cerebellar hemorrhage

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15
Q

Left PCA territory strokes signs

A

Right hemianopia; right hemisensory symptoms; dysmemory; alexia without agraphia

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16
Q

Right PCA territory stroke signs

A

Left hemianopia; left hemisensory symptoms and left visual neglect

17
Q

PCA territory infarcts are caused mostly by…

A

Embolism to the PCAs arising from the heart, aorta, or VAs

18
Q

Lacunar strokes occur in anterior or posterior circulations…

A

BOTH

19
Q

Lacunar Pure motor stroke signs

A

Weakness of arm, face, and leg on one side of the body without sensory, visual, or cognitive or behavioral signs.

20
Q

Lacunar Pure sensory stroke signs

A

Paresthesiae on one side of the body and limbs and face, without motor, visual, or cognitive abnormalities.

21
Q

Lacunar Dysarthria-clumsy hand syndrome signs

A

Slurred speech and clumsiness of one hand

22
Q

Lacunar Ataxic hemiparesis signs

A

Weakness and Ataxia of the limbs on one side of the body

23
Q

Treatment for cardiac embolism stroke, arterial dissection and acute large artery occlusions

A

Heparin and later warfarin

24
Q

Lacunar infarction and nonocclusive atherosclerotic lesions treatment

A

Antiplatelet drugs-aspirin, clopidogrel, a combo of aspirin and modified-release dipyridamole, or cilostazole

25
Q

Other general treatments for strokes

A

Preventing risk factors: HTN, DM, obesity, HPLD, Smoking

26
Q

Signs of Subarachnoid Hemorrhage

A

Sudden headache, often vomit, and temporary interruption in behavior

27
Q

SAH cause

A

Bleed from an aneurysm at the Circle of Willis

28
Q

SAH treatment

A

Preventing rebleeding and vasocontriction

Clipping or coiling the aneurysm
CCBs to minimize vasoconstriction and delayed brain ischemia

29
Q

Most common brain vascular malformation

A

Developmental venous anomalies

30
Q

Developmental venous anomalies (DVAs) are

A

Anomalous veins usually separated by morphologically normal brain parenchyma

31
Q

How to treat brain vascular malformations

A

Can use Medical, surgical, interventional obliteration, and radiotherapy

x Neurology 200 (25 decks)

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