Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathoma LAH > Neuro: 17.4: Cerebrovascular Disease > Flashcards

Neuro: 17.4: Cerebrovascular Disease Flashcards

1
Q

Why are Berry aneurisms susceptible to rupture?

A

they lack a media layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common site of an intracerebral hemorrhage?

A

the basal ganglia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name 3 ways that an ischemic stroke can develop.

A
  1. thrombus
  2. embolus
  3. lacunar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name 3 highly vulnerable areas of the brain because of their location in a watershed area.

A
  1. pyramidal neurons of cortex layers 3,5, and 6
  2. pyramidal neurons of the hippocampus
  3. purkinje layer of the cerebellum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which race has an increased risk of Berry aneurisms?

A

blacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What happens in severe global cerebral ischemia? What is the outcome?

A
  • diffuse necrosis of the brain
  • death or a chronic vegetative state
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a Berry aneurism?

A

a thin-walled, saccular out pouching of a BV that lacks a media layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Dx?

  • a bleed on the bottom of the brain
A

a subarachnoid hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which BV feeds the surface of the cerebral cortex?

A

the middle cerebral artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does an intracerebral hemorrhage present?

A
  • HA
  • n/v
  • coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What will a lumbar puncture show in subarachnoid hemorrhage?

A

xanthochromia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

From which artery do the lenticulostriate vessels branch off of?

A

the middle cerebral artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Hemiballismus?

A
  • a mvmt disorder characterized by a sudden, wild flailing of 1 arm +/- the ipsilateral leg
  • *** “Half of body ballistic”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where do atherosclerotic plaques usually develop?

A

at arterial branch points

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is another name for a Berry aneurism?

A

Saccular aneurism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a subarachnoid hemorrhage?

A

bleeding into the subarachnoid space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

If the focal neurologic deficits last less than 24 hours, then it’s called a _________.

A

transient ischemic attack (TIA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why does an embolic stroke cause hemorrhagic infarcts, but a thrombotic stroke causes a pale infarct?

A
  • embolus can be lysed by body –> blood returns
  • thrombus can’t be lysed –> pallor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where do lacunar strokes most often occur?

A

in the lenticulostriate vessels of the deep brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes intracerebral hemorrhage?

A

rupture of Charcot-Bouchard microaneurisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Where do Berry aneurisms most frequently occur?

A

in the anterior Circle of Willis (branch points of the anterior communicating artery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are horizontal lines of necrosis in the brain cortex layers called?

A

cortical laminar necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the macrophages of the brain?

A

microglia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

This is a thin-walled, saccular out pouching of a BV that lacks a media layer.

A

a Berry aneurism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What happens microscopically from time 0 up to 1 day post-ischemic event?

A

red neurons present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How long can neurons survive ischemia before undergoing necrosis?

A

3-5 mins

27
Q

Which BV feeds the deep structures of the brain, including the basal ganglia?

A

the lenticulostriate vessels

28
Q

If the focal neurologic deficits last more than 24 hours, then it’s called a _________.

A

ischemic stroke

29
Q

What does gliosis refer to?

A

reactive astrocytes lining the cystic space with CT

30
Q

Which conditions are Berry aneurisms associated with?

A
  • Marfans
  • ADPKD
  • Ehlers-Danlos
  • coarctation of the aorta
31
Q

What is intracerebral hemorrhage?

A

bleeding into the brain parenchyma

32
Q

What is a Charcot-Bouchard microaneurism? How do they occur?

A
  • microaneurisms of the lenticulostriate vessels
  • HTN –> hyaline arteriosclerosis –> weakening of BV wall
33
Q

Name 4 general causes (and their underlying pathology) resulting in global cerebral ischemia.

A
  1. low perfusion (atherosclerosis)
  2. acute decrease in blood flow (shock)
  3. chronic hypoxia (anemia)
  4. repeated episodes of hypoglycemia (insulinoma)
34
Q

Where does a thromboembolus causing an ischemic stroke most commonly occur in the brain?

A

the middle cerebral artery

35
Q

How does a subarachnoid hemorrhage present?

A
  • a sudden headache (“the worse HA of my life”)
  • nuchal rigidity
36
Q

What happens in moderate global cerebral ischemia? What is the outcome? Give an example.

A
  • infarcts to watershed areas
  • damage to highly vulnerable regions
  • ex: pyramidal neurons of cortex layers 3,5, and 6
37
Q

Dx?

  • a bleed in the parenchyma of the brain
A

an intracerebral hemorrhage

38
Q

What happens microscopically from time 1 day up to 1 week post-ischemic event?

A

inflammatory cells present (neutrophils, microglial cells)

39
Q

What does a lacunar stroke involve?

A

the small BVs in the brain that undergo hyaline arteriolosclerosis

40
Q

Intracerebral hemorrhage is a complication of _____.

A

HTN

41
Q

What lesions characteristically causes Hemiballismus?

A

a lesion of the contralateral subthalamic nucleus (eg, lacunar stroke)

42
Q

What happens to the BVs in hyaline arteriolosclerosis?

A

the lumen is narrowed by fibrosis

43
Q

What is xanthochromia? What causes it?

A
  • a yellow tinge to the CSF in a lumbar puncture
  • bilirubin breakdown products
44
Q

Where is the hippocampus located? What is its function?

A
  • in the temporal lobe
  • to transfer info to long-term memory
45
Q

What is a mvmt disorder characterized by sudden, wild flailing of 1 arm +/- the ipsilateral leg?

A

Hemiballismus

46
Q

The rupture of Charcot-Bouchard microaneurisms causes ______.

A

intracerebral hemorrhage

47
Q

A lesion of the contralateral subthalamic nucleus (eg, lacunar stroke) causes what movement disorder?

A

Hemiballismus

48
Q

What will the ischemic infarction look like due to embolus?

A

a hemorrhagic infarct in the periphery of the cortex

49
Q

What is the most common source of a thromboembolus causing an ischemic infarct in the brain?

A

the L heart (A-fib)

50
Q

What happens microscopically from time 1 week to 1 month post-ischemic event?

A

granulation-like tissue –> cystic space formation with gliosis and astrocytes

51
Q

What will the ischemic infarction look like due to thrombosis?

A

a pale infarct in the periphery of the cortex

52
Q

What is the end result of liquefactive necrosis in the brain?

A

a fluid-filled cystic space surrounded by gliosis

53
Q

What are the 2 major causes of cerebrovascular disease? Which is more common?

A
  1. more common = ischemia
  2. hemorrhage
54
Q

What happens in mild global cerebral ischemia? What is the outcome? Give an example.

A
  • transient confusion
  • complete recovery
  • ex: an insulinoma
55
Q

What is a watershed area of circulation?

A

an area fed by the very end of a circulation

56
Q

What are the 3 layers of a BV wall?

A
  • intima (inner)
  • media (middle)
  • adventitia (outer)
57
Q

What are the 2 types of ischemic cerebrovascular disease that can occur?

A
  1. focal
  2. global
58
Q

What are the 2 types of hemorrhagic cerebrovascular disease that can occur?

A
  1. intracerebral
  2. subarachnoid
59
Q

What is cortical laminar necrosis?

A

horizontal lines of necrosis in the brain cortex layers

60
Q

What causes hyaline arteriolosclerosis?

A
  • HTN
  • diabetes
61
Q

What is one of the earliest findings on microscopy of an ischemic stroke? When does this present?

A
  • red neurons
  • 12 hours post-event
62
Q

What is the most common cause of a subarachnoid hemorrhage?

A

rupture of a Berry aneurism

63
Q

What kind of necrosis is seen in an ischemic stroke?

A

liquefactive

Pathoma LAH (77 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions