W22-L6: Stroke Flashcards
Definition of stroke
Development of a focal or global neurologic deficit related to a vascular event
What are the mechanisms of infarction?
- Inadequate supply due to pump failure
- Inadequate supply due to narrowed vessel lumen
- Vessel occlusion by embolus
36 hours after a cerebral infarct what do you see on a gross specimen?
Swelling
Days to weeks after an infarct what do you see on a gross specimen?
Liquefactive necrosis
Months to years after an infarct what do you see on a gross specimen?
Abscesses where necrosis has occured
Why do people with cerebral infarction die?
- Involvement of vital centres
- Cerebral swelling
- Pneumonia
- Cardiovascular disease
- Pulmonary Thromboemolism
Causes of intracerebral haemorrhage
- Hypertensive small vessel disease
- Amyloid angiopathy
- Tumour
- Vascualitis
What characterises hypertensive haemorrhage?
Presence of small vessel disease (Hyaline arteriolosclerosis)
Where does hypertensive haemorrhages usually occur?
- Basal ganglia, thalamus
- Lobar white matter
- Cerebellum
- Pons
What is cerebral amyloid angiopathy?
Deposition of Aß amyloid in walls of superficial supratentorial blood vessels
What is cerebral amyloid angiopathy associated with?
Superficial haemorrhages and alzheimer’s disease
Causes of subarachnoid haemorrhage?
- Rupture of saccular aneurysm
- Extension of intracerebral haemorrhage
Risk factors for developing saccular aneurysm?
- Sex, age
- Polycystic kidney disease
- Hypertension
- Smoking, alcohol
Where do saccular aneurysms occur?
Sites of congenital weakness at arterial bifurcations (anterior circulation more than posterior)
What are the favoured sites for saccular aneuryms?
Bifurcation of MCA
Junction of ICA and post. comm artery
-Anterior Comm artery
