Pathology of Crebro-vascular disease

Question 1

Brainsupply of the brainstem

Answer 1

vertebral arteries and basilar artery

Question 2

What is the middle cerebral artery a continuatio of?

Answer 2

the internal carotid(s)

Question 3

What is iscahemia? Hypoxia?

Answer 3

ischaemia = low blood flow
hypoxia = low oxygen

Question 4

What are the 3 main causes of localised interrupted blood supply?

Answer 4

-Atheroma and thrombosis

thromboembolus

anneurysm rupture

Question 5

What can happen to an atheroma to severely narrow the lumen of artery?

Answer 5

get thrombosis ->severly narrowed

Question 6

What issue in the vessles could a tia be due to?

Answer 6

stenosis and ischaemia due to atheroma and thrombosis of the carotics

Question 7

How long in brain before hypoxia/anoxia?

Answer 7

a few minutes

Question 8

What s classically wedge shapped infarct due to?

Answer 8

Localised area of brain death - regional cerebral infarct.

Reflects where an artery supplies, so usually due to no/too little blood flow through that artery

Question 9

What is gliosis?

Answer 9

fibrosis in the brain, due to the glial cells.

Question 10

WHy do cerebral arteries hprone to aneurysims? WHy?

Answer 10

Because they are thinned walled, because they don’t need the muscle around them to constrict and divert blood because the brain always needs perfusion.

Question 11

What happens when an artery ruptures (2)

Answer 11

the blood flows out and so compresses the surrounding brain tissue. the vessel goes into spasm and this reduces the blood supply

Question 12

2 common sites of ruptures?

Answer 12

Basalganglia - microaneurysms in hypertensive patients

Circle of Willis - Berry aneurysm (also more common in hypertensive patients)

Question 13

What is a berry aneurysm?

Answer 13

it looks like a berry?!

Question 14

What cna aberry aneyrysm bleed lead to?

Answer 14

sub arachnoid haemorrhage

Question 15

What are some causes of low o2 in blood?

Answer 15

CO2 poisoning
Respiratory failure
Near drowning

Question 16

What can cause inadequate supply of blood flow?

Answer 16

Cardiac arrest, hypotension, brain swelling

Question 17

Give 3 eg of brain injury caused by generalised interrupted blood supply and/or hypoxia

Answer 17

Hypotension
Cardiac arrest
Complex case

Question 18

What causes watershed infarcts

Answer 18

Hypotension and so reduced perfusion of the brain, which is exacerbated further away from the cerebral arteries, and so causes ischaemia and infaction in the distal regions supplied by the middle, posterior and frontal arteries , causing infarction on the borders between areas supplied

Question 19

Whatr causes laminar cortico necrosis?

Answer 19

necrosis due to total anoxia of the brain, on the outsides