histopath - cerebrovascular path

Question 1

Define stroke

Answer 1

> 24hours

• focal/global loss of cerebral function
• inadequate vascular perfusion

Question 2

Most common site for cerebral thrombosis

Answer 2

1. Carotid bifurcation

2. Basilar artery

Question 3

Most common site for cerebral embolus

Answer 3

Middle cerebral artery

Question 4

Typical site of embolism in TIA?

Answer 4

ophthalmic branch of internal carotid

Question 5

Ix in TIA to attempt to confirm Dx?

Answer 5

Carotid USS

Question 6

Initial management of TIA

Answer 6

Aspirin + dipyridamole +/- carotid endarterectomy

Question 7

If <3h since stroke, what is the management

Answer 7

thrombolytics + aspirin +/- dipyridamole

Question 8

Cause of global cerebral ischemia

Answer 8

Failure of systemic circulation eg HF

Question 9

3 non-traumatic forms of cerebral haemorrhage?

Answer 9

• Intraparenchymal haemorrhage
• Subarachnoid haemorrhage
• Arteriovenous malformations

Question 10

Main RF for intraparenchymal haemorrhage

Answer 10

Hypertension

Question 11

Most common site of intraparenchymal haemorrhage

Answer 11

Basal Ganglia

Question 12

RFs for subarachnoid haemorrhage

Answer 12

PCKD
Ehlers Danlos
Aortic Coarctation

Question 13

Most common cause + site of subarachnoid haemorrhage

Answer 13

Carotid bifurcation

Question 14

Tx of subarachnoid haemorrhage from rupture berry aneurysms?

Answer 14

coil - stops blood flow through weak vessel area

Question 15

coup

Answer 15

where impact occurs

Question 16

Contracoup

Answer 16

opposite side to where impact occurred

Question 17

Contusion - tends to affect which lobes?

Answer 17

Frontal and temporal

Question 18

Viral causes of meningitis in a neonate? give 4

Answer 18

Echovirus
Coxsackie
HIV
Mumps

Question 19

Indolent, childhood brain tumour

Answer 19

Pilocytic astrocytoma

Question 20

Tumour in the ventricles, leading to hydrocephalus

Answer 20

Ependymoma

Question 21

neurofibromatosis type 2 is associated with which brain tumour?

Answer 21

Meningioma

Question 22

2 main types of cerebral oedema

Answer 22

• Vasogenic (leak)

- Cytotoxic (2ndary to vessel injury)

Question 23

How does cerebral oedema resolve itself? i.e. where does the fluid go - state 3 ways

Answer 23

1) into blood via AQP4 in foot processes
2) into subarachnoid CSF
3) into ventricles

Question 24

Normal CSF flow in da brain

Answer 24

Choroid plexus –> lateral vent –> 3rd vent –> 4th vent –> spinal cord OR subarach space

Question 25

2 types of hydrocephalus

Answer 25

1) Communicating (problem with CSF resorption into venous sinuses)
2) Non-communicating (obstruction to CSF flow)

Question 26

Presentation of cerebral arteriovenous malformation

Answer 26

Headache, seizure, haemorrhage, focal signs

Question 27

Wtf is a cavernous angioma

Answer 27

Collection of large weak capillaries with no parenchyma between them

Question 28

Average age of presentation of a cavernous angioma? how do they present?

Answer 28

> 50yo with headache/haemorrhage/focal neuro Sx