Blood supply, Hemorrhage and herniation Flashcards
(32 cards)
Epidural hematoma
Beeding into:
Common site:
Source:
Between skull and periosteal layer of dura mater
Pterion or squamous portion of temporal bone
middle meningeal a.
Subdural hematoma
Bleeding into:
source:
between dura and arachnoid
VENOUS source
Subarachnoid hemorrhage
common finding:
source:
common finding in severe head injury, more common is rupture of aneurysm
source: circle of willis; cerebral a
“thunderclap headache”
Intracerebral (subpial) hemorrhage
(hemorrhagic stroke)
source:
bleeding within brain substance (stroke)
usually from middle cerebral a
clinical - hypertension or degenerative arterial disease
Subfalcine herniation
also called a cingulate or falcine or falx herniation
supratentorial compartment: displaces brain tissue under falx cerebri
may compress anterior cerebral a (ACA)
frontal lobe and parietal love
may evolve into transtentorial herniation
Transtentorial herniation
also called central herniation
displaced downward toward the tentorial notch
Compromises upper brainstem, CN3 and possibly lower structures
may compress basilar a and posterior cerebral as.
Uncal Herniation
Uncus (and frequently portions of parahippocampal gyrus) extruded over the edge of tentorium cerebelli and through the tentorial notch
Ipsilateral CN3 palsy, contralat hemoplasia
Kernohan syndrome
Tonsillar herniation
Cerebellar tonsils through foramen magnum
compression of medulla and upper cervical spinal cord
medulla- cardiac and respiratory centers
CN2 can be affected by:
ICA
anterior cerebral a
anterior communicating a
CN3 can be affected by:
superior cerebellar
posterior cerebral
posterior communicating
CN6 can be affected by:
AICA labyrinthine (internal acoustic) a
CN5 can be affected by:
superior cerebellar a
CN7 can be affected by:
AICA
Anterior cerebral A. supplies what surfaces:
most of the medial and superior surface of the frontal and parietal lobes
Middle cerebral a. supplies what surfaces:
lateral surface of frontal and parietal lobes and superior part of temporal lobe
Posterior cerebral a. supplies what surfaces:
occipital lobe and inferior temporal lobe
what are the border zones
areas in between arteries
susceptible to damage under conditions of sudden systemic hypotension or hypoperfusion
A1 of ACA
(precommunicating segment)
ICA to anterior communicating a
A2 of ACA
(infracallosal segment)
anterior communicating a to where rostrum and genu of corpus callosum meet
A3 of ACA
(precallosal segment)
arches of genu of corpus callosum to where vessels turn caudal
A4 of ACA
(supracallosal segment)
superior to corpus callosum
A5 of ACA
(postcallosal segment)
caudal to corpus callosum
M1 of MCA
(sphenoidal or horizontal segment)
ICA to bifurcation at insula
M2 of MCA
(insular segment)
bifurcation at insula to circular sulcus of insula
