Stroke Flashcards
Multifocal, synchronous haemorrhages are usually associated with what?
Systemic pathology - typically hypercoagulative states
What percentage of strokes are due to ischaemia?
75
How do cerebral infarcts appear in the days to weeks after the initial event?
“Porridge like”
Necrotic
What is a pathology that commonly predisposes vessels for haemorrhage?
Hyaline atheriolosclerosis
Congophilic angiopathy is a risk factor for which type of stroke?
Cerebral haemorrhage
In which part of the circulation is saccular aneurysms more common, anterior or posterior?
Anterior
What event can commonly occur after embolic strokes?
Embolism can lyse or dissipate and the infarcted area be reperfused causing a cerebral haemorrhage
What is a lacunar stroke?
Infarct resulting for the occlusion of a small vessel supplying a deep area of the brain
What are some risk factors for stroke?
Age
Hypertension
Cardiovascular disease
Diabetes
Hyperlipidaemia
Hypercoagulative states
Obesity
Smoking
Where are the most common sites of atherosclerosis in the circle of Willis?
Vertebral arteries
Basilar arteries
Branching of ICA
MCA
T/F Damage to vital brain centres are the most common cause of death after a stroke
False, that is rare
What is a probe-patent interatrial septum?
A deformation in closure of the foramen ovale present in 1/3 of people that can rarely allow venous emboli to get into the arterial system
Why is it important to attempt to remove blood after an cerebral haemorrhage?
It can be vasospasmic
It can contribute to ICP
What is the most common cause of large artery occlusion?
Embolism
What is an endoarterectomy?
A procedure to remove atherosclerotic plaque from the lumen of an artery
Common cause of non-traumatic subarachnoid haemorrhage?
Rupture of berry aneurysms (or other types of aneurysms)
Is what type of vessels are cerebral infarctions most likely to arise?
Small vessels
What causes cerebral amyloid angiopathy?
Deposition of Abeta amyloid in the walls of superficial small vessesl
What are the three mechanism of that cause cerebral infarction?
Hypoperfusion due to pump failure
Narrowed vessel
Embolism
What type of necrosis do you get in the brain?
Liquefactive
What is the problem with arteriovenous malformations?
High pressure blood can enter the venous system which can’t handle the high pressure
What are the most common direct causes of dead after a stroke?
Pneumonia
Cardiovascular disease
Pulmonary thromboembolism
What is the most common cause of small vessel occlusion?
Thrombosis
How do infarcts appear months to years after the initial event?
Cytic spaces filled with CSF
What make a vascular event silent?
The patient isn’t aware of its occurrence
What are some causes of non-infectious, vegetative heart valves?
Hypercoagulative state
Deformed valve
How do neurones appear microscopically as they die?
They initially swell then become hypereosinophilic and shrink
What occurs in brain tissue in the hours after an infarction?
Cytotoxic swelling of damaged area and adjacent swelling of white matter > Increased ICP > Herniation
