Reading Questions Flashcards
What is the most frequent cause of clinically significant nontraumatic subarachnoid hemorrhage is?
Rupture of a saccular aneurysm
What is another word for saccular aneurysm?
Berry aneurysm
In 1/3rd of cases, when does rupture of a saccular aneurysm occur?
when there is an acute increase in ICP like straining at stool or orgasm
What is the clinical symptom of saccular aneurysm rupture?
Sudden, excruciating headache known as THUNDERCLAP HEADACHE and rapid LOC
What percentage of affected individuals with a rupture of a saccular aneurysm die from the first bleed?
25-50%
What patients have an increased risk of aneurysms?
patients with autosomal dominant polycystic kidney disease
What percentage of aneurysms bleed per year?
1.3%
What size of an aneurysm causes rupture 50% of the time?
1cm or greater
What aneurysms occur intracranially?
Saccular Atherosclerotic Mycotic Traumatic Dissecting
Which aneurysms are found in anterior circulation?
Saccular
Dissecting
Traumatic
Mycotic
Which aneurysms are fusiform and commonly involve the basilar artery?
Atherosclerotic aneurysms
What do nonsaccular aneurysms usually manifest as?
cerebral infarction due to vascular occlusion
What does hypertension cause?
hyaline arteriolar sclerosis of deep penetrating arteries and arterioles that supply the basal ganglia, the hemispheric white matter, and brain stem
What are minute aneurysms less than 300 micrometers in diameter called?
Charcot-Bouchard Microaneurysms
What are lacunes or lacunar infarcts?
small cavitary infarcts
few millimeters in size
found in deep gray and white matter, pons, and internal capsule
What is caused by rupture of small caliber penetrating vessels?
small hemorrhages that resorb anf form slit hemorrhage surrounded by brownish discoloration
What is acute hypertensive encephalopathy associated with?
sudden sustained increases in diastolic blood pressure to greater than 130 mmHg
What is acute encephalopathy characterized by?
increased ICP Global cerebral dysfunction headaches confusion vomiting convulsions coma
What are the signs and symptoms of generalized TB meningitis?
headache
Malaise
Mental confusion
vomiting
What does chronic TB meningitis lead to?
arachnoid fibrosis and hydrocephalus from interference with resorption of CSF
What are brain abcesses caused by?
bacterial infections
What are predisposing conditions for brain abcesses?
Acute bacterial Endocarditis
Cyanotic Congenital heart Disease
Chronic Pulmonary Infections
What are brain abcesses?
discrete destructive lesions with central liqueficative necrosis surrounded by a rim of vascularized granulation and fibrous tissue
What is caused by rupture of a brain abcess?
ventriculitis
Meningitis
Venous Sinus thrombosis
What is viral encephalitis?
parenchymal infection of the brain that is almost invariably associated with meningeal inflammation = meningoencephalitis
What is a prion disease?
infectious disease in which the causative agent is an abnormal form of a cellular protein
What are some types of prion diseases?
Creutzfeldt-Jakob Disease
Scrapie in sheep
Bovine Spongiform Encephalopathy = Mad Cow Disease
What is the prion protein?
PrPsc which is resistant to proteolysis
What is Creutzfeldt-Jakob Disease?
rapidly progressive dementing illness that can cause death within 7 months
Who does CJD typically affect?
individuals over the age of 70
What are the effect of Thiamine deficiency (beriberi)?
Wernicke encephalopathy
What is Wernicke encephalopathy symptoms?
abrupt onset of confusion
Abnormalities in eye movement
Ataxia
If treatment for beriberi is delayed what syndrome may occur?
Korsakoff Syndrome
What can deficiency of Vitamin B12 lead to?
Anemia and Subacute Combined Degeneration of the Spinal Cord
Mild ataxia and lower extremity numbness and tingling
What is Huntington Disease?
autosomal dominant movement disorder associated with degeneration of the striatum
What is Huntingtons disease characterized by?
involuntary jerky movements of all parts of the body
What are some early cognitive symptoms of Huntington Disease?
forgetfullness
Thought and affective disorders
progression to dementia possible
What does Huntington Disease carry a risk for?
suicide
What is the cause of Huntington Disease?
CAG trinucleotide repeat expansions in protein huntingtin
