Pathoma: Cerebrovascular Disease Flashcards
What type of stroke is most common?
Ischemic (accounting for 85%)
What four things can cause global cerebral ischemia?
Anemia (leading to hypoxia)
Atherosclerosis of a major artery to the brain
Poor perfusion (i.e., shock)
Repeated episodes of hypoglycemia
Moderate global ischemia can lead to death of vulnerable cell populations. What is it called when this happens to a layer of pyramidal cells?
Cortical laminar necrosis, appearing as a distinct line of dead neurons at cortical layers 3, 5, or 6
Differentiate ischemic stroke from transient ischemic attack.
Ischemic strokes are defined as episodes of ischemia that lead to symptoms that persist for more than 24 hours, while transient ischemic attacks lead to symptoms that subside within 24 hours.
Strokes can arise from emboli or thrombi. Which is more likely to lead to a hemorrhagic infarction?
Emboli are more likely to lead to a hemorrhagic infarction because they lyse faster than thrombi (which start at an atherosclerotic plaque that ruptured)
Thrombotic strokes are more likely to cause ___________ than embolic strokes.
pale infarctions (i.e., not hemorrhagic infarctions)
Where is a classic location for lacunar strokes?
The lenticulostriate nuclei, because those structures are fed by small arteries that branch off of the MCA
Describe the progression of lacunar infarction pathology.
Starts out with liquefactive necrosis Red neurons appear (at 12 hours) Neutrophils and microglia arrive Granulation-like tissue forms Cystic structure with gliosis
Rupture of Charcot-Bouchard microaneurysms most often occurs at what site?
The basal ganglia (this describes intracerebral hemorrhagic stroke)
What syndrome might present with xanthochromia?
Subarachnoid hemorrhage –xanthochromia is yellowing of the CSF due to bilirubin breakdown products
The only condition that leads to bleeding on the bottom of the brain is _____________.
subarachnoid hemorrhage – because the blood is pulled down by gravity
