10.6 Cerebrovascular Disorders

Question 1

anticoagulation CI in what type of stroke

Answer 1

hemorrhagic

Question 2

nonhemorrhagic strokes caused by

Answer 2

thrombosis (use anticoagulants / fibrinolytics)

Question 3

emboli most likely from and to

Answer 3

from heart wall

to middle cerebral artery

Question 4

acute infarct

• gross findings
• microscopic findings

Answer 4

grossly

• soft and edematous tissue
• hard to tell where infarct starts and stops

micro

• pale tissues
• red neurons
• neutrophils

Question 5

subacute infarct

• gross findings
• microscopic findings

Answer 5

gross

• distinct boundary
• gelatinous and friable tissue

micro

• macrophages
• gliosis (reactive astrocytes)

Question 6

remote infarct

• gross
• microscopic

Answer 6

gross
- cystic cavity (hole in brain)

micro
- hole surrounded by gliosis

Question 7

selective vulnerability of hypoxic/ischemic damage

Answer 7

neurons more sensitive than glial cells, especially

• CA1 of hippo (sommer sector)
• purkinje cells of cerebellum
• pyramidal neurons in neocortex (III and V)

Question 8

rupture of a saccular / berry aneurysm causes what type of hemorrhage

Answer 8

subarachnoid hemorrhage

Question 9

saccular / berry aneurysms

• common locations
• defect in

Answer 9

anterior circulation, near branch points

defect in media of vessel

Question 10

predisposing factors for saccular / berry aneurysms

Answer 10

cigarette smoking

hypertension

autosomal dominant polycystic kidney disease

Question 11

complications of saccular aneurysms

Answer 11

rebleed

vasospasm –> ischemic injury

meningeal fibrosis –> obstruct CSF flow

Question 12

tiny infarcts are called

Answer 12

lacunar infarct

Question 13

Amyloid beta40 deposits in walls of medium and small meningeal and cortical vessels

Answer 13

cerebral amyloid angiopathy

Question 14

distended, thin-walled vessels without intervening brain tissue

Answer 14

cavernous malformation/angioma

Question 15

dilated, thin-walled vascular channels separated by normal brain tissue

Answer 15

capillary telangiectasia

Question 16

dilated veins

Answer 16

venous angiomas

Question 17

inflammation of vessels in subarachnoid space and brain tissue, some may be caused by VZV

• dx
• tx

Answer 17

granulomatous angiitis of the CNS

steroids and other immunosuppresive agents

Question 18

young person w/ recurrent strokes and may have Notch3 gene mutation

• dx
• histo

Answer 18

CADASIL (cerebral autosomal dominant arteriopathy w/ subcortical infarcts and leukoencephalopathy)

concentric thickening of blood vessel wall of white matter and leptomeningeal arteries

basophilic, PAS-positive granules

granular deposits in blood vessels on EM