Lecture 63 - Neurovascular Anatomy

Question 1

The Monro-Kellie Doctrine describes how the brain regulates ______ with growth of a mass occupying lesion within the skull. Both the _____ volume and _____ are decreased as the mass grows. Thus, the compliance of the brain is great initially, but when its capacity for compliance is nearly reached, the rate of increase in _____ exponentially rises.

Answer 1

ICP

Venous volume

CSF

ICP

Question 2

Poisuille’s Law

flow = __________

Answer 2

flow = (8 x n x L)/r⁴

So changes in the radius will have the greatest change in flow.

Question 3

Pial arteries are on the surface of the brain and descend into ______-_____ space as penetrating artierioles accompanied by perivascular nerves. These penetrating arterioles give rise to ________ arterioles that supply the cerebral microcirculation known as the Neurovascular unit.

Answer 3

Virchow-Robin space

Parenchymal arterioles

Question 4

As you ascend the Common Carotid to the Internal Carotid, it follows this path:

Cervical part (no _____) –> _______ part (encased in bone) –> Cavernous Sinus part –> Cerebral part (which branches into the ______, then the Posterior _______ further up, and then the ______ artery even further up.

Answer 4

No Branches

Petrosal

Opthalmic artery

Posterior Communicating artery

Choroidal artery

Question 5

Know the branches of the Anterior Cerebral Artery in the following diagram.

Answer 5

Question 6

MCA strokes are the quintessential strokes in neurology, as they result in _______ (ipsilateral or contralateral?) Hemiplegia.

Answer 6

Contralateral

Question 7

The Basilar artery is formed from the coallescence of the 2 ascending _______ arteries (one from each side).

Answer 7

Vertebral arteries

Question 8

Know the major veins in the following diagram.

Answer 8

Question 9

How will a patient with an infarct in one of their Anterior Cerebral Arteries present? What about both?

How will a patient present with occlusion of MCA?

How will a patient present with occlusion of PCA?

Answer 9

ACA –> They will present with CONTRALATERAL hemiplegia of the LOWER limb with occlusion of 1 ACA. Both results in bilateral paralysis of the Lower limbs AND imparied sensation.

MCA –> Contralateral hemiplegia of UPPER extremities and face. If LEFT MCA affected –> aphasia

PCA –> Hemianopsia in both eyes and symptoms of Weber’s syndrome.

Question 10

Empty Delta Sign refers to a thrombosis in the ____ ____ ____, and is most commonly seen in pregnant women. The thrombosis appears dark in what should be white on MRI.

Answer 10

Superior Sagittal Sinus