Pathology of cerebro-vascular disease

Question 1

What are the segments that the middle cerebral arteries branch to form?

Answer 1

Cortical segments
Sylvian segments
Horizont segment
Lateral lenticulostriate arteries

Question 2

What does the anterior cerebral artery supply?

Answer 2

Frontal and medial parietal lobes

Question 3

What does the middle cerebral artery supply?

Answer 3

Lateral parietal and temporal lobes

Question 4

What does the posterior cerebral artery supply?

Answer 4

Occipital and inferior temporal lobes

Question 5

Where do sinuses drain?

Answer 5

Superior sagittal sinus and straight sinus drain to the transverse sinus, then sigmoid sinus then jugular vein

Question 6

What are sinuses sin the brain fed by?

Answer 6

Bridging veins

Question 7

What is the function of emissary veins?

Answer 7

Link veins outside the skull

Question 8

What is a stroke?

Answer 8

Focal neurological deficit due to disruption of the blood supply

Question 9

What is a neurological deficit?

Answer 9

Loss of function affecting specific region of CNS

Question 10

What are the major features of a stroke?

Answer 10

Focal neurological deficit
Confusion, difficulty speaking/understanding speech
Difficulty seeing
Difficulty walking, dizziness, balance/coordination loss
Severe headache with no known cause
Unconciousness

Question 11

What can cause an interruption in blood supply?

Answer 11

Vessel wall
Blood flow and pressure
Blood constituents

Question 12

What problems wth the vessel wall can cause an interruption in the blood supply?

Answer 12

Abnormality of wall

Outside pressure

Question 13

What problems with the blood constituents can cause interruption in the blood supply?

Answer 13

Thrombosis of arteries

Bleeding due to anticoagulation, reduced platelets and clotting factors

Question 14

What are the main causes of stroke?

Answer 14

Atheroma and thrombosis causing ischaemia
Thromboemolism causing ischaemia
Ruptured aneurysm causing haemorrhage

Question 15

What are the major categories of cerebra-vascular event?

Answer 15

Transient ischaemic attack
Minor stroke
Disabling stroke

Question 16

What is a TIA?

Answer 16

Cerebro-Vascular event where symptoms and signs last <24 hours

Question 17

What is a minor stroke?

Answer 17

Signs and symptoms last >24 hours but minor neurological deficit

Question 18

What is a disabling stroke?

Answer 18

Signs and symptoms last >24 hours with persisting disability that impairs independence

Question 19

What does O2 ischaemia cause?

Answer 19

Hypoxia/anoxia

Permanent damage to neurones

Question 20

What are the causes of ischaemic infarct?

Answer 20

Atherosclerosis
Thrombosis
Embolism
Hypotension
Arterial spasm
Systemic vascular disease
Mechanical compression
Venous obstruction

Question 21

What are the features of a regional cerebral infarct?

Answer 21

Wedge shaped
Soft and becomes cystic
Lose grey matter definition
Yellow discolouration
Tissue disintegration
Congested vessels
Swelling of surrounding brain tissue

Question 22

What is the histology of an ischaemic infarct?

Answer 22

Loss of neurones
Foamy macrophages
Gliosis

Question 23

Where do haemorrhage strokes typically occur?

Answer 23

Bifurcations
Basal ganglia
Circle of Willis

Question 24

What % of strokes are haemorrhage?

Answer 24

~15%

Question 25

What happens in the basal ganglia with a haemorrhage stroke?

Answer 25

Microaneurysms form

Question 26

What happens in the circle of Willis with a haemorrhage stroke?

Answer 26

Berry aneurysm forms

Can cause subarachnoid haemorrhage

Question 27

What is the most common group for a haemorrhage stroke?

Answer 27

Hypertensive

Question 28

What are the causes of general problems with blood supply/hypoxia?

Answer 28

Low O2 in blood
Inadequate blood supply
Inability to use O2

Question 29

What can cause low O2 in blood?

Answer 29

CO poisoning
Near drowning
Respiratory arrest

Question 30

What can cause inadequate supply of blood?

Answer 30

Cardiac arrest with immediate rests
Hypotension
Brain swelling

Question 31

What can cause the ability to use O2?

Answer 31

Cyanide poisoning

Question 32

What general disruption would hypotension cause?

Answer 32

Watershed infarction due to poor perfused tissues in watershed areas

Question 33

What are watershed areas?

Answer 33

Interface of artery persuasion areas

Question 34

What general disruption would cardiac arrest cause?

Answer 34

Cortical infarction due to lack of blood flow to brain and available oxygenated blood