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Neurosurgery Resource > Neurovascular > Flashcards

Neurovascular Flashcards

1
Q

Where does the anterior intracranial circulation originate from?

A

Internal carotid arteries

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2
Q

Where does the posterior intracranial circulation originate from?

A

Vertebral arteries (join to form basilar artery)

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3
Q

What connects the right and left anterior cerebral arteries?

A

Anterior communicating artery

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4
Q

What part of the cerebral hemispheres does the anterior cerebral artery supply?

A

Medial part back to parietal lobe

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5
Q

What does the middle cerebral artery supply?

A

Lateral hemispheres

Basal ganglia

Internal capsule

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6
Q

From which artery does the vertebral artery arise?

A

Subclavian artery

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7
Q

What is the main branch of the vertebral arteries?

A

Posterior inferior cerebellar arteries

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8
Q

The posterior cerebral arteries come off which artery?

A

Basilar artery

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9
Q

What is supplied by the posterior cerebral arteries?

A

Occipital cortex and thalamus

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10
Q

Which arteries connect the anterior and posterior circulations?

A

Posterior communicating artery

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11
Q

Identify the arteries of the circle of Willis

A
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12
Q

What are the two parts of the brain’s venous drainage?

A

Cerebral veins

Dural venous sinuses

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13
Q

What do the dural venous sinuses contain that allow for CSF absorption?

A

Arachnoid granulations

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14
Q

The superior sagittal sinus drains blood into which sinuses?

A

Right and left transverse sinuses

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15
Q

Blood drains from the transverse sinuses into which vein?

A

Internal jugular vein

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16
Q

The superficial cerebral veins drain into which sinus?

A

Superior sagittal sinus

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17
Q

The deep cerebral veins drain into which sinus?

A

Straight sinus

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18
Q

What is an arteriovenous malformation?

A

A complex tangle of arteries and veins connected together with one or more fistulas

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19
Q

What is the commonest feature of an AVM?

A

Haemorrhage

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20
Q

Give some other clinical features of AVMs

A

Seizures

Progressive neurological deficit

Headache

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21
Q

What is the main investigation used for AVMs?

A

Catheter angiography

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22
Q

What investigation is used in an AVM emergency?

A

CTA

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23
Q

How can AVMs be managed?

A

Surgical excision

Stereotactic radiosurgery

Endovascular coiling

24
Q

What occurs in subarachnoid haemorrhage?

A

The presence of blood in the subarachnoid space

25
Q

What is the main cause of an SAH?

A

Head trauma

26
Q

What is the main cause of non-traumatic SAH?

A

Berry aneurysm rupture

27
Q

Give some clinical features of SAH

A

Thunderclap headache

Neck stiffness & photophobia

N + V

Confusion

28
Q

What imaging is used to diagnose an SAH?

A

CT

29
Q

How is SAH managed?

A

CT angiography - identifies location and allows for endovascular coiling

30
Q

Give some neurological complications of SAH

A

Vasospasm

Re-bleed

Hydrocephalus

Seizures

Hyponatraemia

31
Q

What is a cavernous malformation?

A

Well circumscribed benign vascular lesions encompassing sinusoidal spaces

32
Q

Give some clinical features of cavernous malformation

A

Seizures

Progressive neurological deficit

Haemorrhage

33
Q

What is the main investigation used for cavernous malformation?

A

MRI

34
Q

Give some risk factors for cranial aneurysms

A

Older age

Female sex

Smoking

Hypertension

35
Q

Most aneurysms arise in the anterior/posterior circulation

A

Anterior

36
Q

Where are the commonest locations for cranial aneursyms?

A

Junction of anterior communicating artery and anterior cerebral artery

Junction of posterior communicating artery and internal carotid

37
Q

What causes a fusiform aneurysm?

A

Atheromatous degeneration of arterial wall

38
Q

What causes a mycotic aneurysm?

A

Septic emboli

39
Q

How does a posterior communicating artery aneurysm present?

A

Third cranial nerve palsy

40
Q

A large anterior communicating artery aneurysm can compress which structure?

A

Optic chiasm

41
Q

Give some clinical features of basilar aneurysms

A

Headache

Third nerve palsy

Confusion

Drowsiness

42
Q

How are aneurysms treated?

A

Endovascular coiling

Neurosurgical craniotomy + clipping of aneursymal neck

43
Q

What is a transient ischaemic attack?

A

Transient obstruction of blood flow to brain, spinal cord or retina

44
Q

Give some risk factors for a TIA

A

Prior TIA

Hypertension

AF

Diabetes

Smoking

45
Q

Give some clinical features of a TIA

A

Cortical symptoms (facial/limb weakness)

Speech abnormalities

Visual disturbance

CN involvement

Memory disturbance

46
Q

What is the main imaging used for TIAs?

A

MRI

47
Q

What occurs in a cerebral infarction?

A

Part of the brain loses blood supply due to arterial occlusion

48
Q

What occurs in an intracerebral haemorrhage?

A

Bleeding from an artery onto the brain tissue from a rupture or leak

49
Q

Give some neurological findings of stroke

A

Speech disturbance (dysarthia/dysphasia)

Contralateral homonymous hemianopia

Facial weakness

Contralateral limb weakness/sensory loss

50
Q

A total anterior circulation infarct requires all three of what symptoms?

A

Higher cerebral dysfunction (dysphasia)

Homonymous visual field defect

Ipsilateral motor and/or sensory deficit

51
Q

What are signs of a partial anterior circulation infarcts?

A

Two of three of:

Higher cerebral dysfunction

Homonymous visual field defect

Ipsilateral motor/sensory deficit

52
Q

What symptoms can present in a posterior circulation infarct?

A

Ipsilateral CN palsy + contralateral motor/sensory deficit

Bilateral motor/sensory deficit

Cerebellar dysfunction

Isolated homonymous visual field defect

53
Q

Patients with ischaemic stroke that present within 4.5 hours can be treated with what?

A

IV alteplase

54
Q

What drug should be started within hours of ischaemic stroke?

A

Aspirin

55
Q

Patients who have had an ischaemic stroke tend to be on which drug for life?

A

Clopidogrel

Neurosurgery Resource (5 decks)

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