Cerebral Vasculature

Question 1

perfusion demands of the brain

Answer 1

Brain makes up 2% of body weight but it uses:

10-20% of cardiac output
20% of body O2 consumption
66% of liver glucose

Question 2

Blood supply to brain

Answer 2

Vertebral artery
Internal carotid artery
Common carotid artery

Question 3

Circle of Willis

Answer 3

Anterior communicating artery
Anterior cerebral artery 
Internal carotid artery
Middle cerebral artery
Posterior communicating artery
Posterior cerebral artery
Basilar artery
Vertebral artery

Question 4

Venous drainage of the brain

Answer 4

Cerebral veins
Venous sinuses in the dura mater
Internal jugular vein

Question 5

Dural venous sinuses

Answer 5

Superior sagittal sinus
Inferior sagittal sinus
Great cerebral vein ( of Galen)
Straight sinus
Transverse sinus
Confluence of sinuses
Sigmoid sinus

Question 6

Types of haemorrhage

Answer 6

Extradural - trauma, immediate clinical effects (arterial, high pressure)
Subdural - trauma, can be delayed clinical effects (venous, lower pressure) - treat with burr hole to remove blood
Subarachnoid - ruptured aneurysms
Intracerebral - spontaneous hypertensive - manage hypertension

Question 7

Stroke

Answer 7

rapidly developing focal disturbance of brain function of presumed vascular origin and of >24 hours duration

Thrombo-embolic (85%) or haemorrhage (15%)

Question 8

Transient ischaemic attack (TIA)

Answer 8

rapidly developing focal disturbance of brain function of presumed vascular origin that resolves completely within 24 hours

Question 9

Infarction

Answer 9

Degenerative changes which occur in tissue following occlusion of an artery

Question 10

Cerebral ischaemia

Answer 10

Lack of sufficient blood supply to nervous tissue resulting in permanent damage if blood flow is not restored quickly

Question 11

Thrombosis

Answer 11

formation of a blood clot (thrombus)

Question 12

Embolism

Answer 12

plugging of small vessel by material carried from larger vessel e.g. thrombi from the heart or atherosclerotic debris from the internal carotid

Question 13

Risk factors for stroke

Answer 13

Age
Hypertension
Cardiac disease
Smoking
Diabetes mellitus

Question 14

Cerebral artery perfusion fields

Answer 14

Anterior at top and down middle
Middle on sides
Posterior at occipital

Question 15

Anterior cerebral artery stroke symptoms

Answer 15

Paralysis of contralateral structures (leg > arm, face)

Disturbance of intellect, executive function and judgement (abulia)

Loss of appropriate social behaviour

Question 16

Middle cerebral artery stroke symptoms

Answer 16

“Classic stroke”

Contralateral hemiplegia: arm > leg

Contralateral hemisensory deficits

Hemianopia

Aphasia (L sided lesion)

Question 17

Posterior cerebral artery stroke symptoms

Answer 17

Visual deficits - homonymous hemianopia, visual agnosia