CNS Part 3

Question 1

which type of cerebrovascular disease is most common and which is most fatal?

Answer 1

ischemic stroke (due to atherosclerosis)
hemorrhagic (due to uncontrolled BP) worse mortality

Question 2

macroscopically what does the brain look like with cerebral ischemia?

Answer 2

swollen/widened gyri
narrowed sulci
edematous
poor demarcation between grey and white matter

Question 3

dementia brain looks like?

Answer 3

atrophy

Question 4

microscopically what does cerebral ischemia look like?

Answer 4

fails to stain with H and E

Question 5

third leading cause of death and leading cause of major disability in the US

Answer 5

strokes

Question 6

what causes ischemic strokes

Answer 6

thrombosis, embolus, systemic hypoperfusion

Question 7

what causes hemorrhagic strokes

Answer 7

intracerebral hemorrhage, subarachnoid hem, subdural hem, or epidural hem

Question 8

dominant hemisphere stroke (usually left)

Answer 8

right hemiparesis
right hemisensory loss
left gaze preference
right visual field cut
aphasia

Question 9

first 12 to 24 hours after stroke

Answer 9

nvacuolated neurons
red neurons (eosinophilia of neuronal cytoplasm)

Question 10

24 hours after stroke

Answer 10

infiltration by neutrophils begins at edges of lesion where there is still blood supply

Question 11

1-14 after stroke

Answer 11

infarcted area increased macrophages and reactive gliosis

Question 12

gliosis

Answer 12

the end result of infarct
brain trying to heal itself
reactive proliferation of astrocytes

Question 13

first and second stages of gliosis

Answer 13

1st: microgliosis
2nd: astrogliosis: proliferation of astrocytes

Question 14

most common location for ischemic stroke

Answer 14

at carotid bifurcation or in vertebrobasilar artery

Question 15

most common artery affected in ischemic stroke

Answer 15

middle cerebral artery

Question 16

valvular vegetations in SBE associated with what heart condition that can embolize to brain?

Answer 16

atrial fibrillation

Question 17

primary underlying cause of hem stroke

Answer 17

hypertension

Question 18

epidural

Answer 18

above dura

Question 19

most common cause of subarachnoid hemorrhage is

Answer 19

rupture of berry aneurism in circle of willis

Question 20

cerebral brainstem stroke due to what

Answer 20

pathology in vertebral basilar arteries

Question 21

most common type of clinically significant vascular malformation

Answer 21

arterovenous malformations (A/V)

Question 22

macroscopic appearance of A/V malformations

Answer 22

tangled network of wormlike vascular channels

Question 23

syndrome in hypertensive pt with diffuse cerebral dysfunction (HA, confusion, convulsions, vomiting)

Answer 23

hypertensive encephalopathy

Question 24

who gets hypertensive encephalopathy

Answer 24

postpartum women

Question 25

do concussions cause brain damage?

Answer 25

no, just temporary

Question 26

anascoria

Answer 26

pupils different size

• bad sign
• more brain damage than just concussion

Question 27

coup injury

Answer 27

injury at sight of contact

Question 28

contrecoup injury

Answer 28

damage to brain surface opposite to point of contact

Question 29

most common type of skull fracture

Answer 29

linear

Question 30

bones separate at sutures in younger children

Answer 30

diastatic

Question 31

bones in many pieces and driven into brain

Answer 31

comminuted

Question 32

rupture of middle meningeal artery

Answer 32

epidural hematoma

Question 33

damage to bridging veins between brain and superior saggital sinus

Answer 33

sub-dural hematoma

Question 34

basilar skull fracture

Answer 34

raccoon eyes = bilateral periorbital ecchymosis

Question 35

where are sub-dural hematomas

Answer 35

between dura and arachnoid

crescent shaped