Neural Blood Vessels Flashcards
Mild Global Ischemia
Transient confusion, can get complete recovery
Severe Global Ischemia
diffuse necrosis of the brain, usually don’t survive
Moderate Global Ischemia
Infarcts in watershed areas
Cortical laminar necrosis
Pyramidal neurons; Layers 3, 5 &6
Supplies anteromedial surface of brain
Anterior Cerebral Artery
Supplies lateral surface of brain
Middle Cerebral Artery
Supplies posterior and inferior surfaces of the brain
Posterior Cerebral Artery
Primary regulation of cerebral perfusion
pCO2
To decrease ICP
hyperventilation
CL paralysis of upper limb and face
Lesion of MCA in the motor cx area
CL hemiparesis/hemiplegia
Lesion lenticulostriate artery of striatum, internal capsul
CL loss of sensation of lower limbs
Lesion of ACA of sensory cortex
CL loss of sensation of upper and lower limbs and face
Lesion of MCA sensory cortex
CL paralysis of lower limb
Lesion of ACA motor cortex
Infarct of paramedian branches of ASA and vertebral arteries
Medial Medullary syndrome
CL hemiparesis of upper and lower limbs
Lesion of ASA lateral corticospinal tract
Decreased CL proprioception
Lesion of ASA medial lemniscus
IL hypoglossal dysfx, tongue deviates IL
Lesion of ASA causal medulla (hypoglossal nerve)
Decreased pain and temperature from IL face and CL body; dysphagia, hoarseness, IL Horner Syndrome
Lateral medullary (Wallenberg) Syndrome PICA
Supplies the Lateral Medulla - vestibular nuclei, lateral spinothalamic tract, spinal trigeminal nucleus, nucleus ambiguus, sympathetic fibers, inferior cerebellar peduncle
PICA
Supplies Lateral pons - CN nuclei, cestibular nuclei, facial nucleus, spinal trigeminal nucleus, cochlear nuclei, sympathetic fibers
AICA
Supplies Middle and inferior cerebellar peduncles
AICA
Infarct of Middle and inferior cerebellar peduncles
AICA, causes ataxia and dysmetria
Paralysis of face, decreased lacrimation, salivation, decreased taste from anterior 2/3 of tongue, decreased corneal reflex. IL decreased hearing loss
AICA infarct of lateral pons
Supplies occipital Cx and visual cortex
PCA
CL hemianopia with macular sparing
PCA infarct
Lesion causes “Locked-in syndrome”
Basilar artery - conscious patient that can only blink
Aneurysm can cause visual field deficits
ACom
Common site of saccular aneurysm, CNIII palsy
PCom - eye is down and out with ptosis and pupil dilation
Worst headache of life
Subarachnoid hemorrhage (burst of berry aneurysm)
Common location of berry aneurysm
ACom and anterior cerebral artery
Diseases associated with berry aneurysm
ADPKD, Ehlers-Danlos, Marfan
Associated with chronic HTN affecting small BVs, intracerebral hemorrhage
Charcot-Bouchard Microaneurysm
neuropathic pain due to thalamic lesions. Initial sensation of numbness and tinging followed by allodynia
Central post-stroke pain syndrome
Rupture of MMA
Epidural hematoma
Fracture of temporal bone
Epidural hematoma
Hyperdense blood collectioni not crossing suture lines, can cross falx and tentorium
Epidural Hematoma
CT shows a biconvex (lentiform) hyperdense blood collection
Epidural Hematoma
Transtentorial herniation causing CN III palsy
Epidural Hematoma
Bridging Veins
Subdural hematoma
Slow venous bleeding, crescent shaped hemorrhage that crosses cuture lines
Subdural hematoma
Bloody of yellow (xanthochromic) spinal tap
Subarachnoid hemorrhage
Tx with Nimodipine
Subarachnoid Hemorrhage
Charcot-Bouchard Aneurysm of lenticulostriate vessels
Intraparenchymal (Hypertensive) Hemorrhage
Areas of brain most vulnerable to ischemic brain disease
Hippocampus, neocortex, cerebellum, watershed areas
Best imaging modality for 3-30min after ischemic brain disease
MRI
Best imaging for 12-24hrs after ischemic brain disease
noncontrast CT
Histologic features 12-48hrs post brain ischemia
Red neurons
Histologic feature 24-72hrs post brain ischemia
Necrosis + Neutrophils
Histologic feature 3-5days post brain ischemia
Macrophages
Histologic feature 1-2weeks post brain ischemia
Reactive gliosis + vascular proliferation
Histologic feature >2 weeks post brain ischemia
Glial Scar
Most common site of intracerebral hemorrhage
Basal Ganglia
Primary cause of Embolism of Brain
Left heart
Most common area for thrombotic infarction
MCA
Tx of ischemic stroke in under 3hrs
tPA
Brief, reversible episode of focal neurological dysfunction lasting <24hr, (-) MRI
Transient ischemic attack
Main location of CSF return via arachnoid granulation
Superior saggital sinus
Flow of CSF
Lateral ventricle, 3rd ventricle via right and left interventricular foramina of Monro, 4th ventricle via cerebral aqueduct of Sylvius, Subarachnoid space Via foramina Luschka and Magendie
Foramina of Luschka
Drains lateral 4th ventricle
Foramen of Magendie
Drains medial 4th ventricle
Who need to purchase ear plugs?
Jen-nay