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NeuroBats > N E U R O L O G Y > Flashcards

N E U R O L O G Y Flashcards

1
Q

Molecular cell deaths that lead to ischemia:

A

Failure of ATP production - Lactic Acid Accumulation

Free radical formation - peroxidation, disruption of the outer cell and mitochondrial membrane

Glutamate and aspartate released by ischemic cells cause intracellular influx of Na and Ca

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2
Q

Size range of the arteries in Lacunar infarct

Size range of cavities produced

A

50-200 micron

3-15mm (diameter)

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3
Q

Location of Intracerebral hemorrhage

A 
Putamen and adjacent internal capsule
Lobar
Thalamus
Cerebellum
Pons
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4
Q

Location of lacunar infarct

A 
Putamen and Caudate
Thalamus
Basis Pontis
Internal capsule
Deep in the central hemispheral white matter
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5
Q

Percentage of embolic infarcts that develop seizures

A

10%

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6
Q

Hollenhorst plaques

A

Crystalline cholesterol sloughed off from an atheromatous ulcer

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7
Q

Arteriosclerosis dementia

A

Binswanger subcortical leukoencephalopathy

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8
Q

SPARCL Trial

% of Stroke prevention by Atorvastatin

A

3%

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9
Q

Raeder Syndrome

A

ICA Dissection
Ipsilateral Horner Syndrome
Unilateral Headache

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10
Q

Vertebral artery dissection most common location (most mobile area)

A

C1-C2

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11
Q

Arterial dissection that can cause Subarachnoid Hemorrhage

A

Vertebral artery dissection

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12
Q

Moyamoya components

A

Cerebral rete mirabile
- small anastomotic vessels around and distal to the circle of Willis

Segmental stenosis or occlusion of the terminal intracranial parts of both ICA

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13
Q

Binswanger Disease Components:

A

Dementia
Pseudobulbar state
Gait disorder

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14
Q

Stroke in the young etiology

A 
Shabu
OCPs
APAS
PFO
Dissection
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15
Q

Thrombotic vessel histopathology

A

Nodular intimal hyperplasia of eccentric distribution with increased mucopolysaccharides and replication of the internal lamina

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16
Q

Degeee of stenosis that needs carotid endarcterectomy (NASCET ECST Trial)

A

70-80%

17
Q

Spot sign on CTA

A

Associated with hematoma expansion

Appearance of contrast within the hemorrhage during CTA

18
Q

MRI of ICH
Blood products and T1-T2 findings
(Osborne)

A

Hyperacute - oxyhemoglobin (iso-bright)
Acute - deoxyhemoglobin (bright-dark)

Early subacute -intracellular methemoglobin (bright - dark)
Late subacute -extracellular methemoglobin (bright - bright)

Chronic - hemosiderin (dark - dark)

19
Q

Lacunar stroke syndromes

A

Pure motor - internal capsule/corona radiata
Pure sensory - lateral thalamus/parietal white matter

Clumsy hand dysarthria - paramedian mid pons (contralateral to the clumsy hand)

Ipsilateral hemiparesis ataxia - pons/mb/internal capsule

20
Q

Hyperperfusion syndrome from Carotid endarcterectomy most common symptom

A

Unilateral severe HA

Focal deficit
Seizures
Cerebral edema/hemorrhage

21
Q

Hypertensive bleeds arteriolar wall

A

Segmental lipohyalinosis

Primary Hypertension hemorrhage are also associated with the false aneurysm (Charcot Bouchard)

22
Q

Unruptured aneurysm

Risk of rupture

A

10% in 25mm

23
Q

CVD among different ages

Prenatal
Perinatal and post natal
Infancy and childhood
Late adult

A

Prenatal -Unilateral cerebral infarction

Perinatal and post natal -etat marbe: Cardiorespiratory failure and generalized ischemia

Infancy and childhood - MELAS

Late adult - Binswanger disease

24
Q

Cerebral blood flow rates

__ml/ 100g/ min

A

Normal
55

Critical level for infarction , reversible after a short period of time
23

Critical level of hypoperfusion that abolishes function that leads to tissue damage regardless of its duration. EEG is slowed
12-23

Causes infarction regardless of duration
Below 10-12

Causes marked ATP depletion
Increased extracellular K, intracellular Ca
Cellular acidosis
6-8

25
Q

Lipid profile that conferes most risk for stroke

A

LDL
followed by
TG

26
Q

Atheromatous plaque

A

ICA -origin from the common carotid artery
VA -cervical part at the junction to form basilar

MCA -stem or at the bifurcation
PCA -proximal
ACA -proximal

27
Q

Atherothrombosis vs Embolism

Which is more common?

A

Embolism

28
Q

ICA lumen

Critical residual size before stroke occurs

A

<2mm

Normal : 5-10mm

29
Q

CHA2 DS2 - VASc scoring

A

CHF / EF <35%
HPN
Age (>65 = 1 ; >75 =2)

DM
Stroke/TIA previous (=2)

Vascular disease:
-coronary/peripheral
Sex

30
Q

PFO stroke risk

A

2%

15% - if with septal aneurysm

31
Q

AF patients

stroke risk

A

6x more than with normal cardiac rhythm

32
Q

Osler Weber Rendu disease mechanism for stroke

A

Pulmonary shunts result in conduits

33
Q

TIA

5 year stroke risk

A

23%

34
Q

ABCD score

A 
Age >= 60 
BP  >=140/90
Clinical : hemiparesis 2
                  Speech only 1
Duration : 60min 2
                    10-59 1
DM
35
Q

After first attack of TIA

% of stroke risk

A

20% in a month

50% in a year

36
Q

Capsular Warning Syndrome

A

Escalating episodes of weakness in the face, arm, and leg culminating in a capsular lacunar stroke

NeuroBats (1 decks)

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