Flashcards in Anatomy and Physiology XIII Deck (25)
How is vasospasm due to blood breakdown of subarachnoid hemorrhage treated?
With nimodipine (calcium channel blocker) (p.424)
What most commonly causes intraparenchymal (hypertensive) hemorrhages?
Systemic hypertension most commonly (p.424)
Name three causes of intraparenchymal hemorrhages other than the most common cause.
Amyloid angiopathy, vasculitis, neoplasm (p.424)
Where do intraparenchymal hemorrhages most commonly occur?
In the basal ganglia and internal capsule, but can also be lobar (p.424)
What is another name for intraparenchymal hemorrhages of the internal capsule?
Charcot-Bouchard aneurysms of the lenticulostriate vessels (p.424)
After how much time of hypoxia does irreversible brain damage begin?
After 5 minutes of hypoxia (p.425)
What areas of the brain are most vulnerable to hypoxia?
The hippocampus, neocortex, cerebellum, and watershed areas (p.425)
What is seen in brain tissue of ischemic disease/ stroke 12-48 hours after the ischemic event?
Red neurons (p.425)
What is seen in brain tissue of ischemic disease/ stroke 24-72 hours after the ischemic event?
Necrosis and neutrophils (p.425)
What is seen in brain tissue of ischemic disease/ stroke 3-5 days after the ischemic event?
What is seen in brain tissue of ischemic disease/ stroke 1-2 weeks after the ischemic event?
Reactive gliosis and vascular proliferation (p.425)
What is seen in brain tissue of ischemic disease/ stroke greater than 2 weeks after the ischemic event?
Glial scar (p.425)
Describe the CT findings of stroke.
Dark on non-contrast CT in approx. 24 hour.s. Bright areas on noncontrast CT indicate hemorrhage (tPA is contraindicated) (p.425)
Describe the MRI findings of stroke.
Bright on diffusion-weighted MRI in 3-30 minutes and remains bright for 10 days (p.425)
How does atherosclerosis lead to ischemic brain disease/ stroke?
Thrombi lead to ischemic stroke with subsequent necrosis. Cystic cavity forms with reactive gliosis (p.425)
How does hemorrhagic stroke cause ischemic brain disease/ stroke?
Through intracerebral bleeding (often due to hypertension, anticoagulation, and cancer (where abnormal vessels bleed)); Also may be caused secondarily due to ischemic stroke followed by reperfusion (due to increased vessel fragility) (p.425)
How does ischemic stroke cause ischemic brain disease/ stroke?
Atherosclerotic emboli block large vessels; lacunar strokes block small vessels (p.425)
How does transient ischemic attack (TIA) cause ischemic brain disease/ stroke?
Ischemic deficits due to focal ischemia (p.425)
Name four possible causes of ischemic stroke.
Atrial fibrillation, carotid dissectioun, patent foramen ovale, endocarditis (p.425)
What is the treatment for ischemic stroke and what is the timeframe to give this treatment?
tPA within 4.5 hours (p.425)
What are the contraindications for giving a patient with ischemic stroke tPA?
Patient must present within three hours of onset of ischemic event and there must not be any major risk of hemorrhage (p.425)
What is a TIA?
Brief, reversible episode of focal neurologic dysfunction typically lasting less than one hour without acute infarction (p.425)
What are typical MRI findings in a patient with a TIA?
Negative MRI findings (p.425)
What are dural venous sinuses?
Large venous channels running through the dura that drain blood from the cerebral veins and receive CSF from arachnoid granulations (p.425)