Chapter 17: Cerebrovascular testing

Question 1

TIA (transient ischemic attack) symptom

Answer 1

fleeting neurological dysfunction
symptoms last less than 24 hours
usually embolic from heart or CCA

Question 2

RIND stands for

Answer 2

resolving ischemic neurologic deficit

Question 3

RIND symptoms

Answer 3

last more than 24 hours

complete recovery usually occurs

Question 4

CVA stands for

Answer 4

cerebrovascular accident

Question 5

CVA symptoms

Answer 5

usually last longer than 24 hours

complete recovery does not occur

Question 6

atheromatous plaque

Answer 6

form of arteriosclerosis
localized accumulations of lipid containing material (atheroma)
smooth muscle cells
collagen
fibrin
platelets

Question 7

atheromatous plaque is formed

Answer 7

within or beneath the intima

Question 8

atheromatous plaque can result in

Answer 8

decreased perfusion to brain

Question 9

fatty streak atheromatous plaque

Answer 9

thin layer of lipid material on intimal layer

Question 10

fibrous plaque atheromatous plaque

Answer 10

accumulation of lipids, collagen, elastic fibers

Question 11

complicated lesion: atheromatous plaque

Answer 11

fibrous plaque that includes fibrous tissue, collage, calcium, cellular debris

Question 12

ulcerative lesion: atheromatous plaque

Answer 12

deterioration of smooth surface of the fibrous cap

Question 13

ulcerative lesion plaque may result in

Answer 13

distal embolization

Question 14

intra-plaque hemorrage

Answer 14

evident on B mode as sonolucent area within plaque

Question 15

thrombus is

Answer 15

collection of RBC trapped within a fibrin network

clumps of platelets may also be present

Question 16

pulsatile mass in neck is usually

Answer 16

tortuous CCA, aneurysms are rare

Question 17

Carotid dissection

Answer 17

sudden tear or trauma
creates a false lumen
blood in false lumen may thrombose
high resistance doppler flow in “blind pouch”

Question 18

Fibromuscular dysplasia FMD is most commonly caused by

Answer 18

dysplasia of media along with over growth of collagen in mid/dst ICA

Question 19

Fibromuscular dysplasia is common in

Answer 19

young women

Question 20

FMD appearance

Answer 20

sting of beads on angiography

Question 21

Carotid body is

Answer 21

a small structure located just above the carotid bifurcation

Question 22

a carotid body tumor is

Answer 22

highly vascular structure that developrs between the CIA and ECA
usually fed by the ECA

Question 23

treatment for carotid body tumor

Answer 23

ligation of feeding vessel

usually the ECA

Question 24

Neointimal hyperplasia is

Answer 24

intimal thickening from rapid production of smooth muscle cells
a response to vascular injury/reconstruction (post cartoid endarterectomy)

Question 25

what happens in neointimal hyperplasia

Answer 25

stripping of endothelium leads to platelet accumulation and smooth muscle cell accumulation

Question 26

out come of neointimal hyperplasia

Answer 26

a significant stenosis may occur within 6-24 months

Question 27

bruit

Answer 27

noise heard from turbulent flow associated with stenosis may not be evident with really tight stenosis (>90%)

Question 28

common sites for bruit evaluation

Answer 28

carotid | subclavian artery

Question 29

taking bilateral blood pressure measurements is recommended why

Answer 29

to detect proximal obstruction (subclavian steel)

Question 30

the left hemisphere of the brain controls what side of body

Answer 30

the right side of body

Question 31

left hemispheric CVA results in

Answer 31

neurological deficits on the right side of the body

Question 32

eye symptoms (amaurosis fugax) suggest diseases of what

Answer 32

ipsilateral ICA

Question 33

symptoms seen with ICA lesion

Answer 33

unilateral paresis unliateral paresthesia aphasia amaurosis fugax

Question 34

unilateral paresis

Answer 34

weakness of slight paralysis on one side of body

Question 35

unliateral paresthesia

Answer 35

prickling or tingling of the skin

Question 36

aphasia

Answer 36

inability to speak

Question 37

amaurosis fugax

Answer 37

temporary partial or total blindeness usuall of one eye

Question 38

myopia

Answer 38

nearsightedness | not consistent with ICA lesion

Question 39

homonymous hemianopia

Answer 39

defective vision in the right and left halves of visual fields not consistent with ICA lesion

Question 40

symptoms seen with MCA lesion

Answer 40

aphasia or dysphasia facial and arm hemiparesis or hemiplegia behavorial changes

Question 41

symptoms with ACA lesion

Answer 41

severe hemiparesis or hemiplegia incontinence loss of coordination

Question 42

symptoms with vertebrobasilar lesion

Answer 42

``` vertigo ataxia diplopia bilat paresthesia or anethisa drop attack ```

Question 43

vertigo

Answer 43

difficulty maintaining equilibrium

Question 44

ataxia

Answer 44

muscular uncoordination (inability to control gait)

Question 45

diplopia

Answer 45

bilat visual blurring or double vision

Question 46

drop attack

Answer 46

falling to ground without loss of consciousness

Question 47

symptoms seen with PCA lesion

Answer 47

dyslexia coma paralysis usually does not occur

Question 48

non localizing symptoms

Answer 48

dizziness syncope severe headache