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Vascular disorders Flashcards

1
Q

systemic hyperperfusion is caused by

A

global cerebral ischemia

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2
Q

Ischemia at what area causes greatest risk of systemic hypoperfusion

A

Watershed zone between ACA and MCA

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3
Q

signs of systemic hypoperfusion

A

Low BP

pallor

sweating

man in a barrel syndrome

anterograde amnesia

intention tremor

nystagmus

ataxia

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4
Q

morphology of global cerebral ischemia at

12-24 hours

A

Red neurons:

eosinophilic cytoplasm

pyknotic nuclei

loss of Nissl Bodies

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5
Q

morphology of global cerebral ischemia at

1-3 days

A

Neutrophilic Infiltration

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6
Q

morphology of global cerebral ischemia at

3-7 days

A

microglia infiltration and phagocytosis

phagocytes have foamy lipid cytoplasm

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7
Q

morphology of global cerebral ischemia at

1-2 weeks

A

Reactive gliosis by astrocytes

Vascular proliferation around necrotic areas

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8
Q

morphology of global cerebral ischemia at

>2 weeks

A

Glial scaring by astrocytes

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9
Q

Macroscopic morphology of global cerebral ischemia at

1 week to 1 month

A

Liquifactive necroisis

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10
Q

Macroscopic morphology of global cerebral ischemia at

>1 month

A

Cystic cavity surrounded by a wall of dense glial fibers

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11
Q

What causes a stroke

A

focal cerebral ischemia

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12
Q

Types of ischemic stroke

A

Embolic

Thrombotic

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13
Q

Associations of an Embolic Ischemic stroke

A

Afib of the left atrium

Myocardial aneurism

Bacterial endocarditis

Atheroemboli

Cardiac shunts

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14
Q

Cause of thrombotic ischemic stroke

A

atherosclerosis

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15
Q

Morphology of thrombotic ischemic stroke

A

hyaline arteriolosclerosis

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16
Q

Associations of thrombotic ischemic stroke

A

HTN

DM

Lacunar infarcts

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17
Q

Presentation of hypertensive hemorrhages

A

Lacunar infarcts

slit hemorrhages

hypertensive encephalopathy

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18
Q

cause of hypertensive hemorrhage

A

malignant HTN

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19
Q

Acute Morphology of hypertensive hemorrhage

A

central core of clotted blood surrounded by a rim of brain tissue showing axonic neuronal and glial changes, as well as edema

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20
Q

Chronic morphology of hypertensive hemorrhage

A
  • cavitary destruction with a rim of brownish discoloration
  • After edema resolves, hemosiderin and lipid-laden macrophages appear eith proliferation of reactive astrocytes
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21
Q

Location of a pure motor lacunar infarct

A

posterior limb of internal capsule

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22
Q

location of a pure sensory lacunar infarct

A

VPL of the Thalamus

23
Q

location of a Sensorimotor lacunar infarct

A

thalamus

internal capsule

caudate

putamen

pons

24
Q

location of am ataxic hemiparesis lacunar infarct

A

base of the pons

internal capsule

25
location of a dysarthria-clumsy hand syndrome lacunar infarct
pons internal capsule
26
slit hemorrhage morphology
slit-like cavity surrounded by a brown discoloration focal destruction pigment laden macrophages gliosis
27
What causes hypertensive encephalopathy
malignant HTN
28
What does hypertensive encephalopathy cause
**cerebellar dysfunction** Progressive HA N/V Confusion Convulsions Coma
29
Morphology of hypertensive encephalopathy
edematous brain, with or without tonsillar herniation petechiae and fibrinoid necrosis of arterioles in the grey and white matter
30
Sequelae of hypertensive encephalopathy
1. Muli-infarct Dementia 2. Binswanger Disease
31
causes of Multi-infarct dementia
cerebral atherosclerosis chronic arteriolar sclerosis vessel thrombi/ emboli from the carotid to the heart
32
Morphology of Binswanger disease
large areas of white matter with myelin and axon loss
33
signs of multi-infarct dementia
dementia gait abnormalities pseudobulbar signs
34
Tyes of hemorrhagic stroke
intracerebral stroke (ICH) Subarachnoid Stroke (SAH)
35
most common **spontaneous** cause of ICH
HTN
36
Most common cause of ICH in kids
Ruptured AVM
37
Most common cause of ICH in the elderly
Cerebral Amyloid Angiopathy
38
Associations of ICH
Coagulation disorders CNS infection Neoplasms Stimulants Traumatic injury
39
40
Etiology of SAH
Ruptured berry aneurysm ruptured AVM
41
Associations of SAH
Angiomas Neoplasms
42
Complications of SAH
Rebleeding Arterial Vasospasm Hydrocephalus
43
most common cause of ganglionic hemorrhages
HTN
44
common locations for ganglionic hemorrhages
**Subcortical (Deep Brain) Regions** Basal ganglia Cerebellar Nuclei Thalamus Pons
45
sequelae of ganglionic hemorrhage
1. hyaline arteriosclerosis of small penetrating arteries 2. focal damage or formation of microaneurysms 3. Charcot Buchard microaneurysms
46
Most common risk factor for lobar hemorrhage
cerebral amyloid angiopathy
47
what is cerebral amyloid angiopathy
amyloidogenic peptides are deposited in the walls of medium and small meningeal and cortical vessels, which weakens the vessel wall
48
most common locations of lobar hemorrhage
occipital lobe parietal lobe
49
Pathogenesis of a non-ruptured berry aneurysm
arterial walls lack internal elastic lamina and media, causing developmental weakness
50
Associations of non-ruptured berry aneurysms
**Autosomal dominant** polycystic kidney disease Ehlers-Danlos Marfan Syndrome Neurofibromatosis Type 1
51
What is an arteriovenous malformation
tangled network of vascular channels in the posterior branch of the MCA
52
clinical presentation of AVM
young male with CHF in childhood: seizure ICH SAH
53
cavernous malformation morphology
popcorn/ mulberry appearance dilated capillaries with an endothelial lining thin adventitia with no elastic fibers and smooth muscle
54
Clinical presentation of Cavernous sinus malformation
seizure ICH SAH progressive neurologic deficits inheritance

Neuro (13 decks)

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