Chapter 17: Cerebrovascular testing Flashcards
TIA (transient ischemic attack) symptom
fleeting neurological dysfunction
symptoms last less than 24 hours
usually embolic from heart or CCA
RIND stands for
resolving ischemic neurologic deficit
RIND symptoms
last more than 24 hours
complete recovery usually occurs
CVA stands for
cerebrovascular accident
CVA symptoms
usually last longer than 24 hours
complete recovery does not occur
atheromatous plaque
form of arteriosclerosis localized accumulations of lipid containing material (atheroma) smooth muscle cells collagen fibrin platelets
atheromatous plaque is formed
within or beneath the intima
atheromatous plaque can result in
decreased perfusion to brain
fatty streak atheromatous plaque
thin layer of lipid material on intimal layer
fibrous plaque atheromatous plaque
accumulation of lipids, collagen, elastic fibers
complicated lesion: atheromatous plaque
fibrous plaque that includes fibrous tissue, collage, calcium, cellular debris
ulcerative lesion: atheromatous plaque
deterioration of smooth surface of the fibrous cap
ulcerative lesion plaque may result in
distal embolization
intra-plaque hemorrage
evident on B mode as sonolucent area within plaque
thrombus is
collection of RBC trapped within a fibrin network
clumps of platelets may also be present
pulsatile mass in neck is usually
tortuous CCA, aneurysms are rare
Carotid dissection
sudden tear or trauma
creates a false lumen
blood in false lumen may thrombose
high resistance doppler flow in “blind pouch”
Fibromuscular dysplasia FMD is most commonly caused by
dysplasia of media along with over growth of collagen in mid/dst ICA
Fibromuscular dysplasia is common in
young women
FMD appearance
sting of beads on angiography
Carotid body is
a small structure located just above the carotid bifurcation
a carotid body tumor is
highly vascular structure that developrs between the CIA and ECA
usually fed by the ECA
treatment for carotid body tumor
ligation of feeding vessel
usually the ECA
Neointimal hyperplasia is
intimal thickening from rapid production of smooth muscle cells
a response to vascular injury/reconstruction (post cartoid endarterectomy)
what happens in neointimal hyperplasia
stripping of endothelium leads to platelet accumulation and smooth muscle cell accumulation
out come of neointimal hyperplasia
a significant stenosis may occur within 6-24 months
bruit
noise heard from turbulent flow
associated with stenosis
may not be evident with really tight stenosis (>90%)
common sites for bruit evaluation
carotid
subclavian artery
taking bilateral blood pressure measurements is recommended why
to detect proximal obstruction (subclavian steel)
the left hemisphere of the brain controls what side of body
the right side of body
left hemispheric CVA results in
neurological deficits on the right side of the body
eye symptoms (amaurosis fugax) suggest diseases of what
ipsilateral ICA
symptoms seen with ICA lesion
unilateral paresis
unliateral paresthesia
aphasia
amaurosis fugax
unilateral paresis
weakness of slight paralysis on one side of body
unliateral paresthesia
prickling or tingling of the skin
aphasia
inability to speak
amaurosis fugax
temporary partial or total blindeness usuall of one eye
myopia
nearsightedness
not consistent with ICA lesion
homonymous hemianopia
defective vision in the right and left halves of visual fields
not consistent with ICA lesion
symptoms seen with MCA lesion
aphasia or dysphasia
facial and arm hemiparesis or hemiplegia
behavorial changes
symptoms with ACA lesion
severe hemiparesis or hemiplegia
incontinence
loss of coordination
symptoms with vertebrobasilar lesion
vertigo ataxia diplopia bilat paresthesia or anethisa drop attack
vertigo
difficulty maintaining equilibrium
ataxia
muscular uncoordination (inability to control gait)
diplopia
bilat visual blurring or double vision
drop attack
falling to ground without loss of consciousness
symptoms seen with PCA lesion
dyslexia
coma
paralysis usually does not occur
non localizing symptoms
dizziness
syncope
severe headache
