MedComplex-Neuro2 Flashcards
_________ are caused by arterial defects that originate during EMBRYONIC development, when the bifurcation of an artery creates a Y-SHAPED configuration.
Berry Aneurysms
Berry Aneurysm: The circumferential muscular layer of the parent vessel, may fail to interdigitate into the two branches, creating a point of congenital muscular weakness, bridged only by ________, the internal elastic lamina, and the slender _________. (no muscle layer)
endothelium… adventitia
Reason for over 90% of Berry’s occurring at branch points in the ________.
Circle of Willis
Berry Aneurysms eventually form a saccular aneurysm evolves, its walls being formed only by _______.
adventitia
Undetected berry’s are found in as many as ___% of persons older than 55 years of age. HOLY SHIT
25%
Rupture of a berry aneurysm causes a life- threatening sub_______ hemorrhage, with a 35-50% mortality during the initial hemorrhage
subarachnoid
Large BERRY aneurysms of the internal carotid complex can produce palsies of WHICH 3 cranial nerves?
3,4,6 (oculomotor, trochlear, abducens)
Berry Aneurysms present as A sudden severe _______ heralds the onset of the SAH and may be followed by coma.
headache
Where are the three preferential sites for a HTN stroke?
1.basal ganglia/thalamus (75%) 2.pons (15%) 3.cerebellum (10%)
What are the 1a and 1b leading causes of death in the US before 2 cancer?
1a.CardioVascular Infarct 1b.CerebroVascular infarct
Occlusion of the TRIFURCATION of the _________ artery is a favored site not only for the lodgement of emboli, but also for atherosclerosis, which promotes thrombosis in-situ.
middle cerebral
Frequent sites of atherosclerosis, the most common site is the _________ artery.
common carotid
WHICH vessels?? are not predisposed to atherosclerosis like the larger arteries, but they can become damaged by hypertension and become stenotic because of secondary arteriolosclerosis, the narrowing causing small ischemic lesions called _______ infarcts.
ParenChymal…LACUNAR
When multiple, these minute parenchymal infarcts can impair cognition and create the entity termed multi-infarct _______.
dementia
Which type of French-ass aneurysms are associated with long-standing HTN?
Char-cot-Bou-chard
Cerebral infarcts are designated as “________” or “______”, and in general, infarcts caused by embolization are the sites of hemorrhage, whereas those initiated by thrombotic occlusion are largely ischemic and therefore the later term.
“Hemorrhagic” or “Bland”
INTERESTING…An embolus occludes vascular flow ABRUPTLY, after which the ischemic region undergoes rapid NECROSIS. The blood vessels that traverse the area of infarction also becomes necrotic and LEAK blood into that region and THUS a EMBOLUS causes ________ cerebral infarcts
HEMORRHAGIC
INTERESTING….Because thrombosis in-situ progresses more SLOWLY, the COLLATERAL vessels also thrombose, thereby guarding against secondary hemorrhage and therefore a THROMBUS causes _______ cerebral infarcts
BLAND
Clinical cerebral infarction signs….Thrombosis of striate arteries, which take origin from the proximal MIDDLE CEREBRAL artery, are commonly occluded by atherosclerosis and thrombosis. The resultant infarct often transects the internal capsule and produces _________ or hemiplegia.
hemiparesis
