Neurovascular Disorder of CNS

Question 1

list examples of neurovascular disorders in CNS

Answer 1

stroke
cerebral aneurysm
arteriovenous malformations
subdural/epidermal hematoma
hydrocephalus
vascular disorders of SC

Question 2

what are the two main arteries that supply the circle of willis

Answer 2

internal carotid A
vertebral A

Question 3

strokes typically occur in the brain due to occlusion of what A

Answer 3

middle cerebral A

Question 4

expressive aphasia

Answer 4

broca’s speech area

Question 5

receptive aphasia

Answer 5

wernicke’s aphasia

Question 6

is the posterior cerebral arteries are impacted, what can is lead to

Answer 6

visual impairments (supply occiput region)

Question 7

what is the 5th leading cause of death and long term disability in US

Answer 7

cerebrovascular accidents

Question 8

what is the major contributing factor for strokes

Answer 8

atherosclerosis (cardiovascular disease)

Question 9

plaque formation in cerebral arteries may be preceded by a “mini stroke”

Answer 9

transient ischemic attack (TIA)

Question 10

what are the two classifications of stroke and describe them

Answer 10

• 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

Question 11

cerebral infarction

Answer 11

cellular death

Question 12

small localized ballooning of an artery in which dilation of the vessel wall may eventually stretch so far that it will rupture

Answer 12

intracranial aneurysm

Question 13

where do most intracranial aneurysms form

Answer 13

base of circle of willis

Question 14

______ aneurysms may not cause any deficits unless they press on other neural structures

Answer 14

unruptured

Question 15

what to ruptured intracranial aneurysms often lead to

Answer 15

immediate death

Question 16

what age do intracranial aneurysms most common in; what are the warning signs; s/s

Answer 16

• common between 40-65 y/o
• typically no warning signs - rarely precipitated by vigorous activity
• sudden severe headache and rapid decline in neurological signs

Question 17

tangle of dilated blood vessels; forms an abnormal communication link between arteries and veins; can form anywhere in brain/brainstem/SC

Answer 17

arteriovenous malformation

Question 18

when may sx start to develop for arteriovenous malformation bc there will typically not be sx present

Answer 18

30 y/o

Question 19

how are arteriovenous malformations found

Answer 19

found accidentally through neurovascular imaging for other reasons

Question 20

what are some sx that can be present with AVM if pt is symptomatic

Answer 20

headaches and seizures –> increases risk for rupture

Question 21

results from tearing of bridging veins between brain surface and dural sinuses

Answer 21

subdural hematoma

Question 22

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

Answer 22

subdural hematoma

Question 23

what populations do subdural hematomas common to form in

Answer 23

older pts from fall or minor head trauma
pts on anticoagulation meds

Question 24

sx of subdural hematoma

Answer 24

mild generalized headache
changes in mental status over time

Question 25

dx and tx of subdural hematoma

Answer 25

contrast CT scan
may require surgical evacuation

Question 26

is epidural hematoma a medical emergency

Answer 26

YES

Question 27

is the tearing of meningeal arteries between skull and periosteum; fast bleeding because under arterial pressure

Answer 27

epidural hematoma

Question 28

what usually causes epidural hematoma

Answer 28

due to head trauma and skull injury

Question 29

hydro-

Answer 29

water

Question 30

cephalus

Answer 30

head

Question 31

excessive fluid in cranium; imbalance with production and absorption of CSF; leads to increased ICP

Answer 31

hydrocephalus

Question 32

occurs with any blockage of ventricular system - trauma, tumor, parasite, inflammation from meninges, encephalitis

Answer 32

hydrocephalus

Question 33

presentation of hydrocephalus

Answer 33

papilledema, seizures, CN and brain stem s/s due to cortical compression

Question 34

how to relieve pressure due to hydrocephalus

Answer 34

shunt placement

Question 35

inflammation to optic disc

Answer 35

papilledema

Question 36

what are the two major sources of blood supply to SC

Answer 36

anterior and posterior spinal arteries
(radicular arteries that arise from vertebral, intercostal, lumbar, iliolumbar, and lateral sacral arteries

Question 37

are spinal cord vascular disorders common or rare

Answer 37

very rare

Question 38

etiology of spinal cord vascular disorders

Answer 38

arises with compression of arterial blood supply due to trauma or tension on the cord; transverse myelitis or congenital vascular malformations

Question 39

what do SC vascular disorders result in

Answer 39

ischemia and necrosis of SC at multiple levels

Question 40

what can SC vascular disorders affect

Answer 40

LMN with comparable LMN s/s
N roots
or just central structures

Question 41

what can be affected by stroke, hematoma, and hydrocephalus

Answer 41

arousal
cognition
memory

Question 42

if a pt is on anticoagulants and strike their head and have sx, what do they do?

Answer 42

they need medical attention to get imaging for bleeding