Ischemic Stroke

Question 1

If resolved after afew minute alone it cold:

Answer 1

Transient ischemic attack

Question 2

Lobes of cerebrum functions
Frontal:
Pareietal:
Temporal:
Occipital:
Cerebellum:
Brain stem:

Answer 2

Frontal: movement + executive function (decision)
Pareital: sensory info
Temporal: hearing, smell, memories, language, facial recognition
Occipital: vision
Cerebellum : muscle coordination
+ balance
Brainstem: vital sighns , heart rate ,bp , gi function, consciousness

Question 3

Important arteries in brain + circle of willis

Answer 3

• anterior cerebral arteriy
• anterior communicating artery
• internal carotid artery
• cerebral arteries
• posterior cerebral artery
• posterior comunicating artery
  -Basilar artery
• vertebral arteries

Question 4

2 ways of ischemic stroke to happen:

Answer 4

• Endothelial cell dysfunction ( take years) mainly smoking user
• embolism

Question 5

Mechanism of endothelial cell dysfunction

Answer 5

• Inflammation of tonica intima - mainly by smoking.
  Damage couse atherosclerosis & plaque leed to obstruct blood flow

Question 6

Common side arteries of atherosclerosis in brain with stroke by endothelial cell dysfunction;

Answer 6

Internal carotid
Middle cerebral artery

Question 7

Second cause of stroke after endothelial cell damage is

Answer 7

Embolism

Question 8

Embolism in brain is typically from

Answer 8

• atherosclerosis + heart embolism

Question 9

Cause of embolism from heart

Answer 9

-Stagnant blood due to atrial fibrillation
- heart attack

Question 10

Mention specifically type of stroke

Answer 10

Lacunar stroke

Question 11

What’s lacunar stroke ?

Answer 11

It involved the deep branches of middle cerebral arteries that feed basal gangelia.

Referring to (leg)

Question 12

Mainly characteristic veiw for lacunar stroke

Answer 12

Cyst that looks like lakes in microscope

Question 13

Mechanism of lacunar stroke

Answer 13

Due hyaline atherosclerosis which makes artery thick and narrow

Question 14

Which people who are in risk factors for lacunar stroke:

Answer 14

HTN
DM

Question 15

Explain ischemic stroke due Shock + what’s specific name

Answer 15

Reduction blood flow cause decreased in blood flow for furthest downstream tissues
So there’s border in brain no good blood after it and tissue further injured.
Called watershed infract

Question 16

How ischemia appears

Answer 16

Ischemic core
Ischemic penumbra

Question 17

Explain mechanism of apoptosis of cell due ischemia

Answer 17

Cytotoxic edema : due +NA inside cell leade to water inter cell and swelling

Build up of reactive oxygen species due +ca inside cell lead to damage lipid in mitochondrial & lysosomes

Leade to apoptosis

Question 18

Explain vasogenic edema due to stroke

Answer 18

-Inflammation damage bbb lead fluid and protein inter brain tissue and accumulate leed to swelling ( vasogeic edema)

Question 19

Mention the effects of vasogenic edema

Answer 19

Congulate herniation
Uncal herniation
Cerebellar tonsil herniation ( dangerous) due compression to brain stim )

Question 20

Which most specifically stroke symptoms

Answer 20

Fast
Facial dropping
Arm weakness
Speech difficulties
Time

Question 21

Diagnosis of ischemic stroke

Answer 21

Ct brain
Angiography: show specific location
Flair sequence mri : distinguishing new from old

Question 22

Treatment of ischmic stroke

Answer 22

-Tissue plasminogen activator ( TPA ) time limit
- Aspirin
Surgery:
- MERCI. Mechanical embolus in cerebral ischemia
- suction removal
- stent
- carotid endarterectomy