Ischemic Stroke Flashcards
If resolved after afew minute alone it cold:
Transient ischemic attack
Lobes of cerebrum functions
Frontal:
Pareietal:
Temporal:
Occipital:
Cerebellum:
Brain stem:
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
Important arteries in brain + circle of willis
- anterior cerebral arteriy
- anterior communicating artery
- internal carotid artery
- cerebral arteries
- posterior cerebral artery
- posterior comunicating artery
-Basilar artery - vertebral arteries
2 ways of ischemic stroke to happen:
- Endothelial cell dysfunction ( take years) mainly smoking user
- embolism
Mechanism of endothelial cell dysfunction
- Inflammation of tonica intima - mainly by smoking.
Damage couse atherosclerosis & plaque leed to obstruct blood flow
Common side arteries of atherosclerosis in brain with stroke by endothelial cell dysfunction;
Internal carotid
Middle cerebral artery
Second cause of stroke after endothelial cell damage is
Embolism
Embolism in brain is typically from
- atherosclerosis + heart embolism
Cause of embolism from heart
-Stagnant blood due to atrial fibrillation
- heart attack
Mention specifically type of stroke
Lacunar stroke
What’s lacunar stroke ?
It involved the deep branches of middle cerebral arteries that feed basal gangelia.
Referring to (leg)
Mainly characteristic veiw for lacunar stroke
Cyst that looks like lakes in microscope
Mechanism of lacunar stroke
Due hyaline atherosclerosis which makes artery thick and narrow
Which people who are in risk factors for lacunar stroke:
HTN
DM
Explain ischemic stroke due Shock + what’s specific name
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
How ischemia appears
Ischemic core
Ischemic penumbra
Explain mechanism of apoptosis of cell due ischemia
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
Explain vasogenic edema due to stroke
-Inflammation damage bbb lead fluid and protein inter brain tissue and accumulate leed to swelling ( vasogeic edema)
Mention the effects of vasogenic edema
Congulate herniation
Uncal herniation
Cerebellar tonsil herniation ( dangerous) due compression to brain stim )
Which most specifically stroke symptoms
Fast
Facial dropping
Arm weakness
Speech difficulties
Time
Diagnosis of ischemic stroke
Ct brain
Angiography: show specific location
Flair sequence mri : distinguishing new from old
Treatment of ischmic stroke
-Tissue plasminogen activator ( TPA ) time limit
- Aspirin
Surgery:
- MERCI. Mechanical embolus in cerebral ischemia
- suction removal
- stent
- carotid endarterectomy
