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MyNeuro > stroke > Flashcards

stroke Flashcards

1
Q

what factors are involved I maintaining cerebral perfusion pressure

A

pH and O2 drop and CO2 raise = vasodilation; opposite vasoconstriction in high CPP

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2
Q

define CPP

A

net pressure gradient causing cerebral blood flow to the brain i.e. mean arterial p - intracranial pressure

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3
Q

define stroke

A

clinical syndrome of abrupt loss of focal brain function lasting over 24 hours (or causing death) that is due to either spontaneous haemorrhage into brain substance or inadequate blood supply to a part of the brain.

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4
Q

what are the differences between to types of stroke

A

ischaemic (occlusion, more common), haemorrhagic (raptured cerebral blood vessels)

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5
Q

what are possible causes for haemorrhaging stroke

A

primary: no structural lesions, secondary: structural lesions i.e. tumour; hypertension, malformations, aneurisms

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6
Q

define TIA

A

Sudden onset, focal disturbance of brain function (occasionally global)

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7
Q

What are the characteristics of TACS

A

ICA/MCA occlusion => contralateral hemiparesis and hemiopia, higher cerebral disfunction => high mortality

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8
Q

What are the characteristics of PACS

A

MCA=> 2/3 of TACS and restricted motor deficit i.e. face or leg or arm only Or isolated cortical signs => high recurrence

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9
Q

What are the characteristics of LACS (lacunar)

A

single perforating artery affected with symptoms related to tissue death => underdiagnosed and silent

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10
Q

What are the characteristics of POCS

A

brainstem, cerebellar or occipital involvement=> with complex presentation

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11
Q

what does fast stands for

A

F=>face weakness, A=>arm weakness; S=> slurred speech, Time => rapid treatment required

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12
Q

What are the symptoms of stroke

A

“o Suggesting bleeding – Headache, Seizure
o Suggesting raised ICP – Heading, vomiting, drowsiness
o Suggesting aetiology – Cardiac symptoms
-ve symptoms”

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13
Q

what are the risk factors for stroke

A

smoking, family history, personal history, diabetes, hypertension AF, hypercholesteraemia, heavy drinking and poor diet

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14
Q

What are common differentials for stroke

A

hypoglycaemia, TIA, epilepsy, space occupying lesion, MS

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15
Q

how effective is CT in diagnosis of stroke

A

good for haemorrhagic , may no show early ischaemic changes or only settle once

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16
Q

how effective is MRI in stroke detection

A

changes seen much earlier on than CT but may not be available i.e. not routinely used

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17
Q

what is normal intracranial pressure what does it raise to with coughing

A

0-10 and 20 mmHg …60 may prevent blood flow to the brain

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18
Q

what are common causes of RICP

A

tumour, haemorrhage, meningitis, cerebral infarct, space occupying lesion

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19
Q

what are the 3 areas scriptable to compression with RICP

A

“o The Cingulate Gyrus
o The Uncus
o The Cerebellar Tonsils
“

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20
Q

What are the symptoms of RICP why do they change over time

A

early morning headache and nausea=> compensated

21
Q

what are the steps of herniation

A

hemispheres squeezed through tentorium => brainstem compression=> bottom cerebellum squeezed into foramen magnum=> further compression of brainstem => suppressed blood supply to the brainstem and its death

22
Q

what are the signs of RICP

A

local signs => reduced consciousness=> coma=> death

23
Q

what is a possible complication of temporal bone infection, what are the symptoms

A

“temporal cerebral abscess.

“

24
Q

what are the symptoms of meningitis

A

a severe headache, neck stiffness, aversion to bright lights, non-blanching

25
Q

what tissue is inflamed in meningitis

A

pia and arachnoid

26
Q

what is a common cause in neonates, 2-5 and 5-30

A

neonates => E.coli or L. monocytogenes; 2-5=> H. Influenza B; 5-39 N. Meningitidis and S pneumoniae

27
Q

What are the characteristics of chronic meningitis

A

granulomatis inflammation of meningeal fibres leading to entrapment of cranial nerves. Cause by M. Tuberculosis or cryptococcal meningitis

28
Q

what are common complication of meningitis

A

death, cerebral infarction, cerebral abscess, subdural empyema

29
Q

What is encephalitis

A

infection of brain tissue usually viral

30
Q

what are common viruses that cause encephalitis and where in the CNS

A

polio=> spinal cord, Harpies simplex => temporal lobe, rubella=> brain stem;

31
Q

what are the actions of cytomegalovirus and toxoplasmosis on nerves

A

takes over cell body machinery and eventually leads to cell death

32
Q

what type of organism is toxoplasmosis

A

protozoa

33
Q

what is the pathological process sin Alzheimer’s and what are the macroscopical changes

A

beta-amyloid deposition leads to neuronal death and shrinkage of the cortex

34
Q

What are the common changes in Alzheimer’s disease

A

memory impairment, language impairment agnosia

35
Q

what are the risk factors for Alzheimer’s

A

family history, some anti-inflammatory drugs, down’s

36
Q

What type of dementia is PD what is the pathology

A

Lewy body dementia => accumulation of alpha-synuclein

37
Q

what are the changes in subfalcine herniations

A

subflacine=> compression of blood flow through ACA=> disturbances of frontal, parietal and corpus callosum and cingulate gyrus pushed under the falx cerebri

38
Q

what are the changes in uncial herniations

A

CN3 damage, secondary haemorrhage into the brainstem, occlusion of PCA (common death in tumour)

39
Q

what are the changes in tonsillar herniations

A

cerebellar tonsils push into jugular foramen and compress the rasp centre of the brainstem

40
Q

what are the two types of damage seen with head injury

A

focal bruising=> coup and contrecoup and diffused axonal injury due to tearing of axons

41
Q

what is the location of subarachnoid haemorrhage

A

between arachnoid and pia

42
Q

what is the location of subdural haemorrhage

A

between dura and arachnoid

43
Q

what is the location of extradural haemorrhage

A

between dura and bone

44
Q

what are the different bleeding vessels in intracranial haemorrhage

A

extradural => middle meningeal a; subdural=> bridging veins,

45
Q

what is the appearance of extradural haemorrhage on CT and why

A

lens shape pilling of the dura

46
Q

who is more susceptible to subdural haemorrhage

A

elderly and alcoholics due to brain shrinkage

47
Q

what is Berry aneurism and why does it occur

A

aneurism at the junctions of circle of wellies; often due to congenitale defects of blood vessels or cystic kidney disease

48
Q

What are the symptoms of subarachnoid haemorrhage

A

Sudden, severe Thunderclap headache

MyNeuro (16 decks)

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