Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuroscience > Stroke > Flashcards

Stroke Flashcards

1
Q

What is stroke?

A

Development of focal or global neurologic deficit related to a vascular event

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Are strokes always visible?

A

Yes

But ‘silent’ vascular events may occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the pathologic processes involved in stroke, and the percentage of patients in which they occur?

A

Infarction (75%)

Haemorrhage (20%)

Subarachnoid haemorrhage (5%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the risk factors for cerebral infarction?

A

Ageing

Hypertension

Cardiac disease

Hyperlipidaemia

Diabetes Mellitus

Hypercoagulable states

Smoking

Obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is cerebral infarction?

A

Necrosis of cerebral tissue in a particular vascular distribution due to vessel occlusion or severe hypoperfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the cause of cerebral infarction?

A

Usually related to arterial obstruction

Can also be arterioles, veins, heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the mechanisms of infarction?

A

Inadequate supply of blood due to pump failure

Inadequate supply of blood due to narrowed vessel lumen (atheroscelrosis, thrombosis, hypertensive vessel thickening, diabetes, amyloid angiopathy)

Vessel occlusion by embolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the causes of occlusion in vessels that cause cerebral infacrtion?

A

Large artery occlusion: thrombotic, may be embolic

Small vessel occlusion: thrombotic, may be embolic

Venous occlusion: thrombotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe this pathology, and how it relates to stroke?

A

Valve vegetations

Due to non-bacterial thrombotic endocarditis

Vegetations can enter the systemic circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe this pathology, and how it relates to stroke?

A

Probe-patent interatrial septum

Potential for thrombus that form in venous system to pass from RA to LA, and then enter the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the most common site for thrombi to develop?

A

Venous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe this pathology, and how it relates to stroke?

A

Atherosclerosis in Circle of Willis

Common sites: vertebral arteries, basilar artery, internal carotid termination artery, proximal middle cerebral artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe this pathology, and how it relates to stroke?

A

Thrombotic vessel occlusion in atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe this pathology, and how it relates to stroke?

A

LEFT: old carotid endarterectomy

RIGHT: recent carotid endarterectomy

Procedure is performed to prevent ulcerated or stenotic atherosclerosis from causing cerebral infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe this pathology, and how it relates to stroke?

A

Swelling 36 hours after cerebral infarct

Due to cell membrane break down, accumulation of fluid and adjacent vasogenic oedema

Also herniation here

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe how a brain looks immediately after cerebral infarction?

A

Initially, appears normal

Then starts to swell

Lose demarcation between grey and white matter

Herniation may occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe this pathology, and how it relates to stroke?

A

Viable neurons centrally, surrounded by axonic-ischaemic neurons

Initally cells swell up, then neurons die, nucleus becomes pyknotic, and eventually disappears

Supporting glial cells have not died

18
Q

Describe this pathology, and how it relates to stroke?

A

Infarct that is days/weeks old

Swelling has gone down

Tissue breaks down

Cerebral tissue necrotic - macrophages mving in to remove dead tissue

19
Q

What is the pathology?

A

Liquefactive necrosis

20
Q

Describe this pathology, and how it relates to stroke?

A

Infarct after months/years

Loss of cerebral tissue

21
Q

Describe this pathology, and how it relates to stroke?

A

BRAIN: Cerebral haemorrhagic infarcts

Due to embolism from cardiac ventricle thrombus (small fragments of thrombus flicked up to brain)

HEART: Wall thinned, aneurysm of ventricle (can lead to thrombus)

22
Q

What is haemorrhagic infarction charcteristic of?

A

Embolic events

23
Q

Describe this pathology?

A

Haemorrhagic transformation in recent infarct

24
Q

Describe this pathology, and how it relates to stroke?

A

Hyaline arterioloscelrosis

Most usually due to hypertension

Vessel balloons > enlargement of vascular lumen > can rupture> haemorrhage or thrombosis

Vascular disease can be at small vessel level such as this

25
Q

Describe this pathology, and how it relates to stroke?

A

Old lacunar infarct

Small vessel occlusion > small infarct

May not be clinically important if in less important areas of brain

May be devastating if in important areas of brain

26
Q

Why do people with cerebral infarction die?

A

Most commonly, die of complications due to them being incapacitated or having other risk factors: pneumonia, cardiovascular disease, pulmonary thromboembolism

May also die due to cerebral swelling or involvement of vital centres

27
Q

Describe the possible complications of raised ICP?

A

Herniation

Brainstem haemorrhages

28
Q

What are the causes of intracerebral haemorrhage?

A

Hypertensive small vessel disease

Congophylic (amyloid) angiopathy

Blood disorders

Tumour

Vasculitis

Vascular malformation

Drugs

29
Q

Which vessels does amyloid angiopathy affect?

A

Small vessels

Much more likely to affect vessels at periphery of brain

30
Q

What is the major cause of hypertensive haemorrhage?

Where does it usually occur?

A

Small vessel disease due to hyaline arteriolosclerosis

Usually occurs in basal ganglia/thalamus, lobar white matter, cerebellum or pons

31
Q

Describe this pathology, and how it relates to stroke?

A

Intracerebral haemorrhage

Due to hyaline arteriolosclerosis

Also an old contralateral ‘slit’ haemorrhage

32
Q

What is cerebral amyloid angiopathy?

A

Deposition of ab amyloid in walls of superficial supratentorial blood vessles

33
Q

What disease states is cerebral amyloid angiopathy associated with?

A

Superficial haemorrhages

Alzheimer’s disease

34
Q

Describe this pathology?

A

Amyloid angiopathy

Senile plaque left of centre

Thickening of walls of small vessels

35
Q

Describe this pathology?

A

Multifocal synchronous haemorrhages

Due to coagulopathy

Must be a systemic problem, due to multifocal lesions

36
Q

Describe this pathology?

A

Rupture of congenital ateriovenous malformation

Following attempted therapeutic embolisation

37
Q

List the non-traumatic causes of subarachnoid haemmorhage?

A

Rupture of saccular/Berry aneurysm

Rupture of other types of aneurysm (mycotic, atherosclerotic)

Extension of intracerebral haemorrhage

38
Q

Describe the risk factors for developing saccular aneurysm?

A

Gender - female

Age - in younger, not elderly

Polycystic kidney disease

Coarctation of aorta

Type III collagen deficiency

Hypertension

Smoking/alcohol

39
Q

Describe this pathology?

A

Ruptured basilar artery due to saccular aneurysm

40
Q

Where do saccular aneurysms usually occur?

A

Sites of congenital weakness at arterial bifurcations

More often in anterior circulation than posterior

Favoured sites: bi/trifurcation of MCA, junction of ICA and posterior communicating artery, anterior communicating artery

41
Q

Describe this pathology?

A

Ruptured anterior communicating artery aneurysm

With inter and intraventricular haemorrhage

42
Q

Describe the complications of aneurysm rupture?

How are they prevented?

A

Subarachnoid haemorrhage

Cerebral oedema and raised ICP

Vasospasm

Infarction

Hydrocephalus due to ventricular obstruction

Prevented by clipping neck of aneurysm to prevent further bleeding

Neuroscience (51 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions