Neurovascular Disorder of CNS Flashcards
list examples of neurovascular disorders in CNS
stroke
cerebral aneurysm
arteriovenous malformations
subdural/epidermal hematoma
hydrocephalus
vascular disorders of SC
what are the two main arteries that supply the circle of willis
internal carotid A
vertebral A
strokes typically occur in the brain due to occlusion of what A
middle cerebral A
expressive aphasia
broca’s speech area
receptive aphasia
wernicke’s aphasia
is the posterior cerebral arteries are impacted, what can is lead to
visual impairments (supply occiput region)
what is the 5th leading cause of death and long term disability in US
cerebrovascular accidents
what is the major contributing factor for strokes
atherosclerosis (cardiovascular disease)
plaque formation in cerebral arteries may be preceded by a “mini stroke”
transient ischemic attack (TIA)
what are the two classifications of stroke and describe them
- ischemic: due to thrombus (forms in brain) or embolus (travels to brain) which results in cerebral infarction or tissue death
- hemorrhagic: leads to abnormal bleeding into extravascular regions of the brain and increased ICP
cerebral infarction
cellular death
small localized ballooning of an artery in which dilation of the vessel wall may eventually stretch so far that it will rupture
intracranial aneurysm
where do most intracranial aneurysms form
base of circle of willis
______ aneurysms may not cause any deficits unless they press on other neural structures
unruptured
what to ruptured intracranial aneurysms often lead to
immediate death
what age do intracranial aneurysms most common in; what are the warning signs; s/s
- common between 40-65 y/o
- typically no warning signs - rarely precipitated by vigorous activity
- sudden severe headache and rapid decline in neurological signs
tangle of dilated blood vessels; forms an abnormal communication link between arteries and veins; can form anywhere in brain/brainstem/SC
arteriovenous malformation
when may sx start to develop for arteriovenous malformation bc there will typically not be sx present
30 y/o
how are arteriovenous malformations found
found accidentally through neurovascular imaging for other reasons
what are some sx that can be present with AVM if pt is symptomatic
headaches and seizures –> increases risk for rupture
results from tearing of bridging veins between brain surface and dural sinuses
subdural hematoma
slow bleeding that causes accumulation of blood in dural space; may become space occupying lesion that leads to brain tissue herniation; compression of brain tissue creates a lesion that may affect consciousness
subdural hematoma
what populations do subdural hematomas common to form in
older pts from fall or minor head trauma
pts on anticoagulation meds
sx of subdural hematoma
mild generalized headache
changes in mental status over time
dx and tx of subdural hematoma
contrast CT scan
may require surgical evacuation
is epidural hematoma a medical emergency
YES
is the tearing of meningeal arteries between skull and periosteum; fast bleeding because under arterial pressure
epidural hematoma
what usually causes epidural hematoma
due to head trauma and skull injury
hydro-
water
cephalus
head
excessive fluid in cranium; imbalance with production and absorption of CSF; leads to increased ICP
hydrocephalus
occurs with any blockage of ventricular system - trauma, tumor, parasite, inflammation from meninges, encephalitis
hydrocephalus
presentation of hydrocephalus
papilledema, seizures, CN and brain stem s/s due to cortical compression
how to relieve pressure due to hydrocephalus
shunt placement
inflammation to optic disc
papilledema
what are the two major sources of blood supply to SC
anterior and posterior spinal arteries
(radicular arteries that arise from vertebral, intercostal, lumbar, iliolumbar, and lateral sacral arteries
are spinal cord vascular disorders common or rare
very rare
etiology of spinal cord vascular disorders
arises with compression of arterial blood supply due to trauma or tension on the cord; transverse myelitis or congenital vascular malformations
what do SC vascular disorders result in
ischemia and necrosis of SC at multiple levels
what can SC vascular disorders affect
LMN with comparable LMN s/s
N roots
or just central structures
what can be affected by stroke, hematoma, and hydrocephalus
arousal
cognition
memory
if a pt is on anticoagulants and strike their head and have sx, what do they do?
they need medical attention to get imaging for bleeding
