Pathology of Cerebrovascular Disease

Question 1

What is the physiological cause of a stroke?

Answer 1

Interruption of supply of oxygen (caused by changes in vessel wall, blood flow or blood constituents) and nutrients causing damage to brain tissue

Question 2

What are the three main causes of localised interrupted blood supply?

Answer 2

Atheroma/thrombosis of artery causing ischaemia
Thromboembolism causing ischaemia
Ruptured aneurysm of a cerebral vessel causing haemorrhage

Question 3

What are the difference between transient and longstanding symptoms?

Answer 3

Transient symptoms- <24hrs, due to reversible ischaemia, tissue still viable
Longstanding symptoms, >24hrs, due to irreversible ischaemia causing localised brain death/infarct

Question 4

What are the common sites of ruptured vessels causing haemorrhagic stroke?

Answer 4

Basal ganglia

Circle of Willis

Question 5

What are the three pathological causes of generalised interrupted blood supply/hypoxia?

Answer 5

Low O2 in blood
Inadequate supply of blood
Inability to use O2 (rare)

Question 6

What are some common causes of low O2 in the blood?

Answer 6

CO2 poisoning
Near drowning
Respiratory arrest

Question 7

What are some common causes of inadequate supply of blood?

Answer 7

Cardiac arrest
Hypotension
Brain swelling (trauma)

Question 8

What kind of brain infarction does hypotension cause?

Answer 8

Watershed infarction

Question 9

What kind of brain infarction does cardiac arrest cause

Answer 9

Cortical infarction