4th Exam: Cerebrovascular Disease Flashcards Preview

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Flashcards in 4th Exam: Cerebrovascular Disease Deck (23)
1

Worse than these big 3 cancers combined:

lung, breast, colorectal

2

How are Stroke and heart disease related?

Essentially different expressions of the same disorder

3

Infarction:

Abnormality: asymmetric, dead tissue is removed, don’t get a scar, get a cavity

4

Is collateral circulation possible in the brain?

yes

5

Infarct in PCA Territory:

Pt has no visual complaint, stroke destroyed inferior R primary visual cortex, lost vision in L superior quadrant of vision, “Left superior quadrant homonymous anopia”

6

Acute ischemic infarct:

Change in nuclei of neurons, change in cytoplasm and background, occasional neutrophils

7

Early organization:

Newly growing capillary wall, formation of granulation tissue, macs & endothelial cells

8

What happens 2-3wk after infarct?

More macs and caps

9

Early cavitation of infarct:

Hemosiderin pigment from breakdown of RBCs, tissue density reduced

10

What is left after infarct cavitation is completed?

Tiny vessels, remnants of “granulation tissue” that participated in organization of necrotic brain tissue

11

Lenticulostriate Arteries:

blocked often, narrow, come off at R angles, small cavitations in lenticulostriate territory: “lacunar” infarcts

12

Cause of hemorrhagic infarction:

reperfusion of infarcted area, interference w venous drainage

13

Intracerebral Hemorrhage:

Most common location: deep gray mater, freq ruptures into ventricle, may originate from tiny microaneurysms (Charcot-Bouchard) which are freq present on lenticulostriate as.

14

Location of intracerebral hemorrhage:

1. Deep gray matter 2. Pons 3. Cerebellum 4. White matter

15

Ppl at high risk for hemorrhages

high BP

16

Cx ft of infarct:

Hx of TIA, onset at rest, min discomfort, sudden onset of focal deficit wo change in consciousness or mentation, mod hypert (occasionally normotensive), clear CSF

17

Cx ft of hemorrhage:

No TIA, onset during activity, headache (often severe), rapidly evolving neurological deficit including state of consciousness, severe hypertension (occasionally moderate), bloody CSF

18

TF? Microaneurysms are often seen in ppl under 65

F. not even that many in older patients

19

Saccular Aneurysms, aka:

congenital or berry

20

Saccular Aneurysms:

Typically at branch points of arteries- congenital weakness in the area, aneurysms enlarge and have a propensity to burst. 1 cm: most dangerous, most common cause of spontaneous (non-traumatic) subarachnoid hemorrhage, trauma & head injuries cause subarachnoid hemorrhages, but if its SPONTANEOUS, it’s berry aneurysm, most saccular aneurysms: in anterior portions of circulation, 50% of ppl w polycystic kidney disease die of berry aneurysm

21

How is a pts ability to read affected by a stroke of left occipital lobe?

No vision in R visual field, R occipital lobe intact, vision in L visual field, route to corpus callosum (language) destroyed, cannot read

22

How is a pts ability to write affected by a stroke of left occipital lobe?

it's not, "Alexia Without Agraphia”

23

TIA sf:

Transient ischemic attack