Neuro - Cerebral Vasculature

Question 1

How much cardiac output does the brain use?

Answer 1

10-20%

Question 2

How much body O2 does the brain consume?

Answer 2

20%

Question 3

How much liver glucose does the brain consume?

Answer 3

66%

Question 4

What are the 2 main blood supplies to the brain?

Answer 4

→ internal carotid artery (off the common carotid artery)

→ vertebral artery (off the subclavian artery)

Question 5

How are the arteries of the brain arranged?

Answer 5

in Circle of Willis
→ from vertebral arteries
→ basilar artery
→ posterior cerebral arteries
→ posterior communicating arteries
→ middle cerebral arteries
→ internal carotid arteries
→ anterior cerebral arteries
→ anterior communicating arteries

Question 6

How does the venous drainage of the brain work?

Answer 6

→ cerebral veins
→ venous sinuses in dura mater
→ internal jugular vein

Question 7

What are the 4 types of inter-cranial haemorrhages?

Answer 7

→ extradural : trauma, immediate clinical effects (arterial, high pressure)
→ subdural : trauma, can be delayed clinical effects (venous, lower pressure)
→ subarachnoid : ruptured aneurysms
→ intracerebral : spontaneous hypertensive

Question 8

What is a stroke (CVA)?

Answer 8

→ cerebrovascular accident

→ rapidly developing focal disturbance of brain function of presumed vascular origin and of >24hrs duration

Question 9

What are the two types of strokes?

Answer 9

→ thrombo-embolic (85%)

→ haemorrhage (15%)

Question 10

What is a TIA?

Answer 10

→ transient ischaemic attack
→ rapidly developing focal disturbance of brain function of presumed vascular origin that resolves in 24 hours
→ warning of a spossible stroke in the future

Question 11

What is the definition of an infarction?

Answer 11

degenerative changes which occur in tissue following occlusion of an artery

Question 12

What is cerebral ischaemia?

Answer 12

lack of sufficient blood supple to nervous tissue resulting in permanent damage if blood flow is not restored quickly

Question 13

What is thrombosis?

Answer 13

formation of a blood clot (thrombus)

Question 14

What is embolism?

Answer 14

→ plugging of smaller vessels by material carried from larger vessel
→ e.g. thrombi from heart or atherosclerotic debris from internal carotid

Question 15

What is FAST campaign for strokes?

Answer 15

→ F = face fallen on one side
→ A = arms, unable to hold them up
→ S = speech slurred
→ T = time to call 999

Question 16

What are the risk factors for strokes?

Answer 16

→ age
→ hypertension
→ cardiac disease
→ smoking
→ DM

Question 17

Which cerebral artery has the biggest perfusion field?

Answer 17

middle cerebral artery

Question 18

What are symptoms of anterior cerebral artery strokes?

Answer 18

→ paralysis of contralateral structures
→ disturbance of intellect, executive function + judgement (abulia)
→ loss of appropriate social behaviour

Question 19

What are symptoms of middle cerebral artery strokes?

Answer 19

→ “classic stroke”
→ contralateral hemiplegia (paralysis of half body, arm > leg)
→ contralateral hemisensory deficits (loss of sense son half of body)
→ hemianopia (loss of one half of visual field)
→ aphasia (L sided lesion)

Question 20

What are symptoms of posterior cerebral artery strokes?

Answer 20

visual deficits
→ homonymous hemianopia (loss of visual fields)
→ visual agnosia (inability to recognise things)

Question 21

Name a-c in this picture.

Answer 21

Question 22

Name all the structures in this diagram.

Answer 22

Question 23

Name the structures in this diagram.

Answer 23

Question 24

What kind of intercranial haemorrhage is this?

Answer 24

Question 25

What kind of intercranial haemorrhage is this?

Answer 25

Question 26

What kind of intercranial haemorrhage is this?

Answer 26

Question 27

What kind of intercranial haemorrhage is this?

Answer 27

Question 28

What major risk factor for stroke is evident here?

Answer 28

Question 29

Which cerebral artery has been occluded in this specimen?

Answer 29

Right middle cerebral

Question 30

What are the features of an extradural haemorrhage?

Answer 30

Trauma
Immediate clinical effects
Arterial bleed, high pressure

Question 31

What are the features of a subdural haemorrhage ?

Answer 31

Trauma
Can have delayed clinical effects
Venous bleed, lower pressure

Question 32

What are the features of a subarachnoid haemorrhage?

Answer 32

Usually ruptured aneurysms

Question 33

What are the features of an intracerebral bleed?

Answer 33

Spontaneous + hypertensive