CNS trauma + Cerebrovascular diseases

Question 1

بسم الله الذي وسع كل شئ علما
______________________
Accumulation of excess amount of fluid in brain parechyma ?

Answer 1

Cerebral edema

Question 2

Causes of cerebral edema?

Answer 2

Vasgogenic edema
Cerebral edema

Question 3

Desrbie vasogenic edema ?

Answer 3

There is damage in the endothelium of cerebral blood vessels increasing BBB permaebility causing accumulaiton of fluid extracellulear casuing vasogenic edema means edema due to Vessel damage

Question 4

Intra cellular accumulation of fluids due to cell membrane injery whether neronal microglia or endothelial called?

Answer 4

Cerebral Cytotoxic edema

Question 5

Compare between vasgoenic and cytotoxic edema in locality

Answer 5

Vasogenic : localized adjacent to inflamation or tumors
Or Generalized
________________
Cytotoxic edema :
In generalized hypoxic or ischemic injury

Question 6

Describe grossly the edematous brain

Answer 6

Brain is swollen
gyri falttened and sulci narrowed
Ventricular cavities compressed
Soft

Question 7

List brain hypoxia causes

Answer 7

Functional : alic2
Altitides low partial pressure of oxygen
Low carrying capacity in Anemia
Carbon dioxide posino9ng
Cyanind Poison causing Less usage of Oxygen in the cells
___________________________
Ischemia due to obstruction + Hypotension

Question 8

Types of cerebral ischemia

Answer 8

Global Cerebral ischemia
occure when there is genralidzed perfusion reduction as cardiac arrest and shock
end with complete recovery in mild cases but in severe death or severly impairments
_________________
Focal cerebral ischemia to loaclized arrea affecting
large vessles emboli or throbosis
Small vessles: Vasculitis

Question 9

Cells affects by global cerebral ishcmeia

Answer 9

Pyramidal Of cortex
Pyramidal of hippocampus
Purkinje in cerebellum

Question 10

Respirator brain

Answer 10

Dead brain in respirator
Dilated congesetd with autolysis

Question 11

Pseudolaminar necrosis uneven distribtion of neuronal loss + gliosis and neocortex
Borderzone “ watershed “ infracts appears in ?

Answer 11

Global cerebral ischemia

Question 12

Focal cerebral ishcmia severity depends on ?
caused by?

Answer 12

Collateral circulation
_______________
Arterial occlusion due to :
Thrombosis of Caroid or cerebral areteris due to atherosclerosis or arhteritsi
Embolic Occlusion : Derived from heart mural thrombosis comlicating MI. AF. or endocarditis
_______________________
Venous occlusion =cancer=SSS thrombosis =bilatereal mulitple hge infarcts
______________________
Non occuliscce compression of cerebral arteris from outside causing infarction

Question 13

Lacunar infarcts
Small infarcts in the deep non cortical white matter or brainstem
Due to ?

Answer 13

Occulstion of Penetraing branches of cerebral arteries
may occur in basal ganglia
caudate and putamen

Question 14

Venous occulsion in Focal ishcemis in brain

Answer 14

Venous occlusion =cancer=SSS thrombosis =bilatereal mulitple hge infarcts

Question 15

MNIN STROKE
Sympotoms <24 hours
by small platlet thrombi + atheroemboli

Answer 15

TIA
Transient ischemia attacks

Question 15

MNIN STROKE
Sympotoms <24 hours
by small platlet thrombi + atheroemboli

Answer 15

TIA
Transient ischemia attacks

Question 16

Acute onset Neurological defecits due to Obstructive Cerebovascular lesions causing infarction or Hge

Question 17

Slowly progeressive decrease in mental dysfunction in cerebral atherosclerois called

Answer 17

Muti-infact dementia

Question 18

Cerebral infactcion causes and casues !

Answer 18

Causes liqufacting necoriss of brain tissue
_________________
Causes :
Arterial occlusion due to atherocslcerosis with thrombosis of internal caroid cerebral vertebral or basialr artery
______________
Embolism from left side of Heart
_______________
Venous thrombosis :
Associated with prenancy and contraceptive

Question 19

infaction gorossly describe !

Answer 19

In beginign Hge
then liqufactive necorsis with cyst

Question 20

Infaction micro describe

Answer 20

After 6 hours the cytoplsam become eosiophilic
during 24 hours: Neurophlic infiltrates
after one day MQ begins to infiltrate !

Question 21

Multiple saccular dilatation on arteries in circle of willis which rupture casues subarachnoid Hge?

Answer 21

Berry Congenital aneyrusm

Question 22

Congential berry casues ?

Answer 22

Congenital weakness of media at side of bidurcation
Weakness of internal elastic lamina
Abnormalitis of Collagen types

Question 23

Polycystic kideny disease is associated with which aneyrusm ?

Answer 23

Berry aneyrusm

Question 24

Commonest aneyrsm in middle CEREBRAL Artery ?

Answer 24

Berry due to weakened wall due to mild infection

Question 25

Intenral caroid and basilar commonest aneysum ?

Answer 25

Atheroscletoic aneyrusm due to cerebral atherocsclerosis

Question 26

Aneyrsum in small vessles less than 300um diamtere ?

Answer 26

Charcot bouchaed micro aneyrusms by HTN
`

Question 27

LENITCULOSTIATE Artireirs aneyrsm

Answer 27

Charcot bouchard microanyrusm

Question 28

Mention effects of cerebral aneyrusms

Answer 28

=Increasing ICP
=RUPTURE CAUSING Subarahcnoid Hge
==Hydrocephalus
It can be laibel to thrombosis and calcification

Question 29

cOMMENEST SITE Of arteriovenous malformation

Answer 29

Middle cerebral artery

Question 30

Cavenous malofrmation or cavnernous angioma

Answer 30

Blood filled sinusoids

Question 31

Capillary telangectasia

Answer 31

Dilated capillaries in normal brain tissue without symptoms

Question 32

Spontanoeus non traumatic Hge
aCCOUNTS FOR 10-20% STROKES
more common in males
Location in Basal ganglia thalmus cerebral cerebellum pons
Causes?

Answer 32

HTN
Casuing
charcot bouchaed microaneyrsm and its rupture causing Hge
+++++++++++++++++++++++++++
also
Beryy aneysm
Aretovenous and caneronus malfomration
Neoplasm
vascultits

Question 33

Sopntaucnosu non traumatic Hge mROPHOLGY ?

Answer 33

[Peticheal Hge”
Massive Hge

Question 34

Effects of Spontanous non traumatic Hge

Answer 34

Hemiplegia
Increased Intracranial tension
causgin tentorial herniation

Question 35

Types of traumatic head injuries

Answer 35

Parenchymal injuries :
concussion
contusion
Diffuse axonal injuries
_____________
Traumatic vascular injury
Hge and Hematoma

Question 36

Concussion

Answer 36

`Trauma with movment of brain back and forth ,causing
altered mental status and loss of Consciousness
-Temporary resp arrest
-Amensia
-Neurological recovery is complete

Question 37

Contusion

Answer 37

Direct parenchymal injury
Coup injury cerebral injry at same side of imapct
Contrecoup injury cerebral injuet at opposite site of impact

Question 38

Diffuxe axonal injury

Answer 38

Injury to white matter with axonal swelling due to acceleation and deceleration
locations:
Corpus callosum ,
Preventricular white matter , Hippocampus.
Cerebral and cerebellar peduncles

Question 39

Traumatic vascular injury

Answer 39

epidural and subdural heamtoma
Traumatic intreacerebral and subarachnoid Hges

Question 40

Epidural heamtoma

Answer 40

between skull and dura
_______________-
Due to rupture of middle meninigeal artery or temoproparietal fracture

Question 41

bETWEEN dura and arachanoid
________________
tear of bridging veins deain brain to dural sinusses

Answer 41

sUBDURAL HHEAMTOMA

Question 42

Risk factors for subdural hematoma ?

Answer 42

Brain atrophy
Anticoagulant
Shaking -whiplash

Question 43

Talk and die syndrome

Answer 43

In Lucid Interval before loss of conscousness epidural hematoma

Question 44

Transtentorial henriation occures in ?

Answer 44

Epidural hematoma

Question 45

Slow venous bleeding +
delayed onset of fradually incrasing headache and confusion

Answer 45

In subdural heamtoma

Question 46

Biconvex shape not crossing suture line in Head CT?

Answer 46

ePIDURAL hematoma

Question 47

Subdural heamtoma in CT

Answer 47

crescent shaped hge crossing suter lines
Gyri apre preserved
Cannot cross falx tentorium

Question 48

الحمدلله رب العالمين