Stroke

Question 1

What is a stroke?

Answer 1

Neurological deficit related to a vascular event

Question 2

What is the most likely cause of brain injury?

Answer 2

75% infarction
20% Haemorrhages
5% Subarachnoid Haemorrhage

Question 3

What is a cerebral infarction due to?

Answer 3

Hypoperfusion or vessel occlusion (normally arterial)

Question 4

WHat type of event is more likely to happen in small arteries?

Answer 4

Thrombus

Question 5

WHat type of event is more likely to happen in large arteries?

Answer 5

Embolous

Question 6

In order for a venous clot to reach the brain what must be present?

Answer 6

Patent Interatrial Septum (1/3 people)

Question 7

What is a vasogenic oedema?

Answer 7

Extracelullar [] of fluid due to disruption of BBB and increased vascular permeability. Responsive to roids and pressure manipulation

Question 8

Cytotoxic Oedema is…

Answer 8

Increased intracellular [] of fluid w/out disruption of BBB . affects both white and grey matter. Happens in stroke and haemorrhage. DOES NOT RESPOND WELL TO TREATMENT

Question 9

Cytotoxic Oedema affects mainly —-1—– whilst vasogenic oedema affects —–2—-

Answer 9

1 White Matter

2 Grey Matter

Question 10

WHat type of necrosis happens in the brain? what happens after resolution?

Answer 10

liquefactive Necrosis, after resolution there is a CSF filled cyst left behind

Question 11

What are lacunar infarctions?

Answer 11

Infarcts caused by occlusion of the small penetrating arteries of the brain deep structures

Question 12

What are the main causes of cerebral haemorrhages?

Answer 12

Hyaline Arteriolosclerosis

Amyloid Angiopathy

Question 13

What are hypertensive haemorrhages caused by?

Answer 13

Rupture of arteriole with Hyaline Arteriolosclerosis

Question 14

Where are hypertensive haemorrhages more likely?

Answer 14

Basal Ganglia/Thalamus
Lobar White Matter
Cerebellum
Pons
NO GREY MATTER

Question 15

What is Cerebral Amyloid Angiopathy?

Answer 15

Deposition of Aß blaques in the wall of of superficial supratentorial blood vessels

Question 16

What are the causes of Subarachnoid Haemorrhages?

Answer 16

Rupture of Aneurysm (*Berry, Mycotic, Atherosclerotic)
Trauma
Extension of intraparenchymal haemorrhage

Question 17

What are berry saccular aneurysm?

Answer 17

Congenital abnormalities at the site of bifurcation of the circle of willis

Question 18

What are some of the risks factors for the rupture berry saccular aneurysm?

Answer 18

Female, Age and hypertension

Question 19

Where are berry saccular aneurysms more likely?

Answer 19

Anterior Circulation

ACA and Anterior Communicating Artery

Question 20

Blood in the brain parenchyma causes vaso—-

Answer 20

Spasms which can cause death of tissue due to hypoxia

Question 21

What do most people with cerebral infarction die of?

Answer 21

Involvement of vital centres
Cerebral swelling
*penumonia
*cardiovascular disease
*pulmonary thromboembolism