Pathology of cerebrovascular disease

Question 1

What vessels give the blood supply to the cortex?

Answer 1

cerebral arteries - A,M,P

Question 2

What arteries give the blood supply to the brainstem?

Answer 2

vertebral and basilar

Question 3

What structure is the circle of willis next to?

Answer 3

optic chiasm

Question 4

In the brain veins do not accompany arteries so where are they found?

Answer 4

dural venous sinuses

Question 5

Stroke definitions

Answer 5

Focal neurological defecit (loss of function affecting a specific region of CNS) due to disruption of blood supply

Question 6

What is the cause of stroke?

Answer 6

Interruption of supply of oxygen and nutrients, causing damage to brain tissue

Question 7

virchows triad

Answer 7

vessel wall
blood flow and pressure
blood constituents

Question 8

Reasons for vessel wall abnormalities

Answer 8

atheroma, vasculitis

outside pressure eg spinal cord compression

Question 9

2 main causes of ischaemic stroke

Answer 9

atheroma and thrombosis

thromboembolism

Question 10

main cause of haemorrhagic stroke

Answer 10

ruptured aneurysm of cerebral artery

Question 11

Difference between atheroma and thrombosis

Answer 11

atheroma causes some narrowing

thrombosis - platelets and fibrin - severe narrowing

Question 12

What territory of the brain do you typically get ischaemia in with atheroma and thrombosis and why?

Answer 12

MCA

likely to occur at carotid bifurcation

Question 13

What is ischaemia?

Answer 13

A relative or absolute lack of blood supply in a tissue or organ

Question 14

Difference between transient and longstanding symptoms

Answer 14

transient <24 hours, reversible damage and tissue still viable
longstanding >24 hours, irreversible damage and brain death - infarct

Question 15

Appearance of infarct

Answer 15

wedge shaped - arterial perfusion territory
soft and then cystic
yellowing, swollen surrounding, tissue disintegration and eventually lose brain matter and have cyst like spaces

Question 16

What is gliolosis?

Answer 16

CNS equivalent of fibrosis

Question 17

left atrial appendage thrombosis is common in which group of people?

Answer 17

those with AF

Question 18

Left atrial appendage thrombosis travels and blocks where?

Answer 18

carotid, aorta as connected to left side of heart

MCA

Question 19

Why do the cerebral arteries have thin walls?

Answer 19

not much muscle

prevent constriction eg after caffeine which would reduce blood supply and perfusion to cerebrum

Question 20

What causes aneurysms to form?

Answer 20

weakening of wall and hypertension

Question 21

2 common sites of ruptured vessels and the kinds of aneurysms

Answer 21

basal ganglia - microaneurysms

circle of willis - berry aneurysms

Question 22

3 reasons for generalised hypoxia

Answer 22

low oxygen in blood eg CO poisoning
inadequate supply of blood eg hypotension
inability to use oxygen eg cyanide poisoning

Question 23

Hypotension causes which kind of infarcts?

Answer 23

watershed

Question 24

In a cardiac arrest what necrosis would follow?

Answer 24

cortical

Question 25

What is a laminar infarct?

Answer 25

lines of necrosis and thinning in the cortex