Pathology of Cerebrovascular Disease Flashcards
Explain the blood supply to different parts of the cortex?
Do veins accompany arteries in the brain?
No they do not
What drains the dura mater?
Large venous sinuses
What is ischaemia?
Lack of blood flow
What is hypoxia?
Lack of oxygen
What is a stroke?
Focal neurological deficit (loss of function affecting a specific region of the central nervous system) due to disruption of blood supply
Vaugly, what is the cause of stroke?
Interruption of supply of oxygen and nutrients, causing damage to brain tissue
What can an interruption in oxygen to the brain be caused by changes in?
Vessel wall
Blood flow (including blood pressure)
Blood contituents
What changes in the vessel wall can cause an interruption of blood supply to the brain?
Atheroma or vasculitis
Outside pressure (strangulation)
Spinal cord compression
Compression of veins
What changes to blood flow can cause an interruption of oxygen delivery to the brain?
Decreased blood flow
Increased blood pressure bursting vessels
What changes to blood constituents can cause interruption to delivery of oxygen to the brain?
Thrombosis of arteries and rarely veins
Bleeding due to anticoagulation
Reduced platelets and clotting factors
In practice, what are the 3 main causes of localised interruptions of blood supply?
Atheroma and thrombosis of artery causing ischaemia
Thromboembolism (for example from left atrium) causing ischaemia
Ruptured aneurysm of cerebral vessel causing haemorrhage
What are the 2 kinds of ischaemia?
Transient symptoms
Longstanding symptoms
What are transient symptoms ischaemia?
Less than 24 hours
Due to reversible ischaemia (transient ischamia attack)
Tissue still viable
What are long standing sympotoms ischaemia?
More than 24 hours
Due to irreversible ischaemia
Causes localised brain death (infarct)