Neuro10

Question 1

What are the 3 subtypes of Ischemic Stroke?

Answer 1

• Thrombotic
  
  • Atherosclerotic plaque
• Embolic
  
  • Thromboemboli
• Lacunar
  
  • 2˚ to hyaline arteriolosclerosis

Question 2

What is the result of a Thrombotic stroke?

Answer 2

Pale infarct at periphery of the cortex

Question 3

What is the result of an Embolic stroke?

Answer 3

Hemorrhagic (bloody) infarct at periphery of cortex

Question 4

What is the most common source of emboli in an Embolic stroke?

Answer 4

Left side of heart (Atrial Fib)

Question 5

What artery is typically involved in an embolic stroke?

Answer 5

Middle Cerebral A.

Question 6

Lacunar stokes commonly involve which vessels?

Answer 6

Lenticulostriate vesels – resulting in small cystic areas of infarction

*Internal capsule & Thalamus

Question 7

What is affected if the lacunar stoke involves the internal capsule?

Answer 7

Motor function

Question 8

What is affected if the lacunar stroke involves the thalamus?

Answer 8

Sensory function

Question 9

Following an ischemic brain stroke, there is irreversible damage after how long?

Answer 9

5 minutes of hypoxia

Question 10

Ischemic stroke results in __________ necrosis.

Answer 10

Liquefied

Question 11

What is the early microscopic finding (12-48 hrs) following an ischemic stroke?

Answer 11

Red Neurons

*Eosinophilic change in cytoplasm of neurons

Question 12

What microscopic finding is seen 24 hours following an ischemic stroke?

Answer 12

Coagulative Necrosis

Question 13

When do you see infiltration of neutrophils following an ischemic stroke?

Answer 13

1-3 days

Question 14

When do you see microglia (CNS macrophages) following an ischemic stroke?

Answer 14

4-7 days

Question 15

What is seen 1-2 weeks following an ischemic stroke?

Answer 15

Reactive Gliosis + Vascular proliferation

*Pathoma - granulation tissue (2-3 weeks)

Question 16

What is seen > 2 weeks following an ischemic stroke?

Answer 16

Glial scar

*Pathoma - Formation of a fluid-filled cystic space surrounded by Gliosis

Question 17

What is the treatment for an ischemic stroke?

Answer 17

tPA within 4.5 hours

so lon as patient presents within 3 hours of onset and there is no risk of hemorrhage

Question 18

What is a Transient Ischemic Attack (TIA)?

Answer 18

Brief, reversible episode of focal neurologic dysfunction typically lasting < 1 hour WITHOUT acute infarction (ø MRI)

*deficits due to focal ischemia

Question 19

What is the main location of CSF return via Arachnoid Granulation?

Answer 19

Superior Sagittal Sinus

Question 20

Where do the dural venous sinuses drain?

Answer 20

Internal Jugular Vein