NEURO Vascular Flashcards
Cerebral Aneurysm
An abnormal focal dilation of an artery in the brain that results from a weakening of the inner muscular layer (the intima) of a blood vessel wall. The vessel develops a “blister-like” dilation that can become thin and rupture without warning
SYMPTOMS:
Nausea and vomiting.
Stiff neck.
Blurred or double vision.
Sensitivity to light.
Seizure.
A drooping eyelid.
Loss of consciousness.
Confusion.
CAUSES:
Smoking.
Blood infection.
High blood pressure (hypertension).
Amphetamine and cocaine use.
Traumatic brain injury (often caused by car crashes).
Atherosclerosis (fatty buildup on blood-vessel walls).
Cerebral Edema
Also known as brain swelling. It’s a life-threatening condition that causes fluid to develop in the brain. This fluid increases the pressure inside of the skull — more commonly referred to as intracranial pressure (ICP).
SYMPTOMS:
Headache.
Neck pain or stiffness.
Nausea or vomiting.
Dizziness.
Irregular breathing.
Vision loss or changes.
Memory loss.
Inability to walk.
CAUSES:
tumor, trauma, hypoxia, infection, metabolic derangements, or acute hypertension.
Cerebrovascular Accident (CVA)
- ischemic, hemorrhagic
A loss of blood flow to part of the brain, which damages brain tissue. An ischemic stroke happens when a blood vessel (artery) supplying blood to an area of the brain becomes blocked by a blood clot. A hemorrhagic stroke happens when an artery in the brain leaks or bursts (ruptures).
SYMPTOMS:
dizziness, numbness, weakness on one side of the body, and problems with talking, writing, or understanding language.
CAUSES:
blood clots and broken blood vessels in the brain
Cluster Headache
Occur in cyclical patterns or cluster periods, are one of the most painful types of headache. A cluster headache commonly awakens you in the middle of the night with intense pain in or around one eye on one side of your head.
SYMPTOMS:
Excruciating pain that is generally situated in, behind or around one eye, but may radiate to other areas of your face, head and neck.
One-sided pain.
Restlessness.
Excessive tearing.
Redness of your eye on the affected side.
Stuffy or runny nose on the affected side.
Forehead or facial sweating on the affected side.
CAUSE:
Doctors do not know exactly what causes cluster headaches. They seem to be related to the body’s sudden release of histamine (chemical in the body released during an allergic response) or serotonin (chemical made by nerve cells) in the area of a nerve in the face called the trigeminal nerve.
Embolism
A blocked artery caused by a foreign body, such as a blood clot or an air bubble. As an embolus moves through the body’s blood vessels, it’s likely to come to a passage it can’t fit through. It lodges there, backing up blood behind it. The cells that normally get their blood supply via this passage are starved of oxygen (ischemia) and die. This condition is called an embolism.
SYMPTOMS:
pain, swelling and tenderness in one of your legs (usually your calf)
a heavy ache in the affected area.
warm skin in the area of the clot.
red skin, particularly at the back of your leg below the knee.
CAUSE:
Most embolisms happen to people who have risk factors for blood clot formation, such as smoking and heart disease. Other risk factors for other types of emboli include high blood pressure, atherosclerosis (buildup of fatty plaque in the blood vessels), high cholesterol, and obesity
Encephalopathy
-ischemic, hypoxic
A term for any diffuse disease of the brain that alters brain function or structure. “Encephalopathy” means damage or disease that affects the brain. It is not a single disease but a group of disorders with several causes. It’s a serious health problem that, without treatment, can cause temporary or permanent brain damage. It happens when there’s been a change in the way your brain works or a change in your body that affects your brain. Those changes lead to an altered mental state, leaving you confused and not acting like you usually do. It can be reversible and irreversible.
Hypoxic ischemic encephalopathy (HIE) is a type of brain dysfunction that occurs when the brain doesn’t receive enough oxygen or blood flow for a period of time.
SYMPTOMS:
Confusion
Memory loss
Personality changes
Trouble thinking clearly or focusing
Some people will also have:
Trouble speaking
Muscle weakness or twitches they can’t control
Eye movements they can’t control
Tremors
Trouble swallowing
Sleepiness
Seizures
CAUSES:
infectious agent (bacteria, virus, or prion), metabolic or mitochondrial dysfunction, brain tumor or increased pressure in the skull, prolonged exposure to toxic elements (including solvents, drugs, radiation, paints, industrial chemicals, and certain metals), chronic progressive trauma, poor nutrition, or lack of oxygen or blood flow to the brain
Encephalo=brain
Hydrocephalus
An abnormal buildup of fluid in the ventricles (cavities) deep within the brain. This excess fluid causes the ventricles to widen, putting pressure on the brain’s tissues. The excess fluid increases the size of the ventricles and puts pressure on the brain.
Cerebrospinal fluid normally flows through the ventricles and bathes the brain and spinal column. But the pressure of too much cerebrospinal fluid associated with hydrocephalus can damage brain tissues and cause a range of brain function problems.
SYMPTOMS:
Infants
a rapid increase in head size
an unusually large head
a bulge on the soft spot (fontanel) on the top of the head
vomiting
problems sucking or feeding
sleepiness
irritability
eyes that are fixed downward (also called “sun setting”) or are not able to turn outward
seizures.
Older kids and Adults
headache
blurred or double vision
nausea or vomiting
problems with balance
slowing or loss of developmental progress like walking or talking
vision problems
decline in school or job performance
poor coordination
loss of bladder control and/or frequent urination
difficulty remaining awake or waking up
sleepiness
irritability
changes in personality or cognition including memory loss.
Older adults
problems walking, often described as feet feeling “stuck”
progressive mental impairment and dementia
general slowing of movements
loss of bladder control and/or frequent urination
poor coordination and balance.
CAUSES
Can be inherited genetically, may be associated with developmental disorders, like spina bifida or encephalocele, or occur as a result of brain tumors, head injuries, hemorrhage or diseases such as meningitis.
Intracranial Hemorrhage (ICH)
- cerebral, subarachnoid, epidural/subdural
Any bleeding within the brain or intracranial vault, including the brain parenchyma and surrounding meningeal spaces. Blood vessels carry blood to and from the brain. Arteries or veins can rupture, either from abnormal pressure or abnormal development or trauma. It is the second most common cause of stroke (15-30% of strokes) and the most deadly.
Epidural hematoma
A hematoma is a collection of blood, in a clot or ball, outside of a blood vessel. An epidural hematoma occurs when blood accumulates between your skull and the outermost covering of your brain.
It typically follows a head injury, and usually with a skull fracture. High-pressure bleeding is a prominent feature. If you have an epidural hematoma, you may briefly lose consciousness and then regain consciousness.
Subdural hematoma
A subdural hematoma is a collection of blood on the surface of your brain.
It’s typically the result of your head moving rapidly forward and stopping, such as in a car accident. However, it could also suggest abuse in children. This is the same type of movement a child experiences when being shaken.
A subdural hematoma is more common than other ICHs in older people and people with history of heavy alcohol use.
Subarachnoid hemorrhage
A subarachnoid hemorrhage is when there’s bleeding between the brain and the thin tissues that cover the brain. These tissues are called meninges. The most common cause is trauma, but it can also be caused by rupture of a major blood vessel in the brain, such as from an intracerebral aneurysm.
A sudden, sharp headache usually comes before a subarachnoid hemorrhage. Typical symptoms also include loss of consciousness and vomiting.
Intracerebral hemorrhage
Intracerebral hemorrhage is when there’s bleeding inside of your brain. This is the most common type of ICH that occurs with a stroke. It’s not usually the result of injury.
A prominent warning sign is the sudden onset of neurological deficit. This is a problem with your brain’s functioning. The symptoms progress over minutes to hours. They include:
headache
difficulty speaking
nausea
vomiting
decreased consciousness
weakness in one part of the body
elevated blood pressure
Migraine Headache
A neurologic disorder that causes a moderate or severe headache. The headache comes in episodes and often comes with nausea, vomiting, and sensitivity to light. Can be felt as a throbbing pain on 1 side of the head. Often happen in stages. These stages may include
1. Prodrome
Hours or days before a headache, about 60% of people who have migraines notice symptoms like:
Being sensitive to light, sound, or smell
Fatigue
Food cravings or lack of appetite
Mood changes
Severe thirst
Bloating
Constipation or diarrhea
2. Aura
These symptoms stem from your nervous system and often involve your vision. They usually start gradually, over a 5- to 20-minute period, and last less than an hour. You may:
See black dots, wavy lines, flashes of light, or things that aren’t there (hallucinations)
Have tunnel vision
Not be able to see at all
Have tingling or numbness on one side of your body
Not be able to speak clearly
Have a heavy feeling in your arms and legs
Have ringing in your ears
Notice changes in smell, taste, or touch
3. Attack
A migraine headache often begins as a dull ache and grows into throbbing pain. It usually gets worse during physical activity. The pain can move from one side of your head to the other, can be in the front of your head, or can feel like it’s affecting your entire head.
About 80% of people have nausea along with a headache, and about half vomit. You may also be pale and clammy or feel faint.
Most migraine headaches last about 4 hours, but severe ones can go for more than 3 days. It’s common to get two to four headaches per month. Some people may get migraine headaches every few days, while others get them once or twice a year.
4. Postdrome
This stage can last up to a day after a headache. Symptoms include:
Feeling tired, wiped out, or cranky
Feeling unusually refreshed or happy
Muscle pain or weakness
Food cravings or lack of appetite
The most common are migraine with aura (also known as a classic migraine) and migraine without aura (or common migraine). Other types include Menstrual migraine. Migraine is a common health condition, affecting around 1 in every 5 women and around 1 in every 15 men.
SYMPTOMS
- severe throbbing pain or a pulsing sensation, usually on one side of the head
- often accompanied by nausea, vomiting, and extreme sensitivity to light and sound.
CAUSES:
For many years, scientists thought migraines happened because of changes in blood flow in the brain. Most now think this can contribute to the pain, but is not what starts it.
Current thinking is that a migraine likely starts when overactive nerve cells send out signals that trigger your trigeminal nerve, which gives sensation to your head and face. This cues your body to release chemicals like serotonin and calcitonin gene-related peptide (CGRP). CGRP makes blood vessels in the lining of your brain swell. Then, neurotransmitters cause inflammation and pain.
Cerebral Infarction
- thrombosis, embolism, common obstructions
Also called ischemic stroke, a cerebral infarction occurs as a result of disrupted blood flow to the brain due to problems with the blood vessels that supply it. A lack of adequate blood supply to brain cells deprives them of oxygen and vital nutrients which can cause parts of the brain to die off. Infarction: obstruction of the blood supply to an organ or region of tissue, typically by a thrombus or embolus, causing local death of the tissue.
Infarction is tissue death or necrosis due to inadequate blood supply to the affected area. It may be caused by artery blockage, rupture, mechanical compression, or vasoconstriction.
A thrombus is a blood clot that forms in a vein. An embolus is anything that moves through the blood vessels until it reaches a vessel that is too small to let it pass. When this happens, the blood flow is stopped by the embolus. An embolus is often a small piece of a blood clot that breaks off (thromboembolus).
Embolus is smaller.
Thrombosis occurs when blood clots block veins or arteries. An embolism is a blocked artery caused by a foreign body, such as a blood clot or an air bubble. The body’s tissues and organs need oxygen, which is transported around the body in the bloodstream.
SYMPTOMS
pain and swelling in one leg, chest pain, or numbness on one side of the body. Complications of thrombosis can be life-threatening, such as a stroke or heart attack.
CAUSES
high blood cholesterol and high blood pressure are at an increased risk of cerebral infarction. Other risk factors include smoking, obesity, a family history of heart disease, diabetes and excessive alcohol consumption
Embolus=plug
Thrombus=blood clot
Tension Headache
Generally a mild to moderate pain that’s often described as feeling like a tight band around the head. A tension-type headache is the most common type of headache, yet its causes aren’t well understood. Tension headaches occur when neck and scalp muscles become tense or contract. The muscle contractions can be a response to stress, depression, head injury, or anxiety. They may occur at any age, but are most common in adults and older teens. It is slightly more common in women and tends to run in families
Tension-type headaches are divided into two main categories — episodic and chronic. Tension-type headaches can be difficult to distinguish from migraines. Plus, if you have frequent episodic tension-type headaches, you can also have migraines.
Unlike some forms of migraine, tension-type headaches usually aren’t associated with visual disturbances, nausea or vomiting. Although physical activity typically aggravates migraine pain, it doesn’t make tension-type headache pain worse. An increased sensitivity to either light or sound can occur with a tension-type headache, but this symptom isn’t common.
A tension headache is the most common type of headache. It can cause mild, moderate, or intense pain behind your eyes and in your head and neck.
A tension headache can feel like a tight band around your forehead.
Most people who experience tension headaches have episodic headaches that occur one or two times per month on average. However, tension headaches can also be chronic.
SYMPTOMS:
Dull, aching head pain
Sensation of tightness or pressure across the forehead or on the sides and back of the head
Tenderness in the scalp, neck and shoulder muscles
CAUSES:
Doctors and medical researchers don’t know what exactly causes tension headaches. Tension headaches may sometimes be linked to muscle tension in the head and neck, or to poor posture.
Research suggests that infrequent tension headaches may be causedTrusted Source by the activation of hyperexcitable peripheral afferent neurons. These are specialized neurons, or nerve cells, that relay sensory information from pain receptors in the body to the brain.
If you get tension-type headaches, you may have abnormalities in your central pain processing. It’s also possible that you may generally have an increased sensitivity to pain.
Someone’s susceptibility to tension headaches is believed to be influenced by genetic factors.
Triggers of tension headaches include:
stress
alcohol
dental problems (such as clenching your jaw and grinding your teeth)
eye strain
dry eyes
fatigue
smoking
a cold or flu
a sinus infection
caffeine
poor posture
emotional stress
not drinking enough water
lack of sleep
skipping meals
Transient Ischemic Attack (TIA)
a stroke that lasts only a few minutes. It happens when the blood supply to part of the brain is briefly blocked. Symptoms of a TIA are like other stroke symptoms, but do not last as long. They happen suddenly, and include: Numbness or weakness, especially on one side of the body.
CAUSES:
smoking.
high blood pressure (hypertension)
obesity.
high cholesterol levels.
regularly drinking an excessive amount of alcohol.
having a type of irregular heartbeat called atrial fibrillation.
having diabetes.
Vascular Lesions of the Spinal Cord
Vascular lesions of the spinal cord. Vascular myelopathies may result from ischemia, venous congestion, arteriovenous malformation and haemorrhage. Vascular diseases of the spinal cord are a group of rare but potentially devastating conditions, whose early and accurate recognition is fundamental for patients’ outcome. Spinal vascular malformations, also known as spinal arteriovenous malformations (AVMs), are the result of an abnormal connection between arteries and veins that occurs within the spinal canal or spinal dural covering. The term spinal vascular malformation includes several distinct types of vascular problems under one name. This group of spinal vascular disorders includes spinal dural arteriovenous fistulas (DAVFs), spinal arteriovenous malformations (AVMs), cavernous malformations and spinal artery aneurysms. This overview focuses on the most common types of spinal vascular malformations: spinal AVFs and spinal AVMs.
