Cerebrovasclar Disorders

Question 1

What is a cerebrovascular disorder?

Answer 1

Damage (block/break) to blood vessels resulting from an underlying vascular disease

Question 2

Why are CVDs the 3rd most common cause of death in developed countries?

Answer 2

CVD is very affected by lifestyle and environmental factors (e.g. high blood pressure - stress/cholesterol)

Question 3

What does the brain need an uninterrupted supply of? Why?

Answer 3

O2 and glucose via the blood

The brain has no reservoir; needs >20% of entire O2 for normal functioning (children need up to 50%)

Question 4

The term for cholesterol?

Answer 4

Hyperlipidermia

Question 5

What are risk factors for CVD that you can’t control?

Answer 5

Age (older = higher risk due to normal deterioration)
Family history (hx of strokes)
Gender (more likely in men)

Question 6

Risk factors for CVD you can control?

Answer 6

Hypertension
Cholesterol
Smoking
Overweight
Poor diet + no exercise
Excessive alcohol (ETOH)

Question 7

Medical conditions which are risk factors for CVD?

Answer 7

Heart disease (atrial fibrillation - irreg <3beat)
IHD - ischemic <3 disease
Diabetes
TIA - transient ischemic attack

Question 8

What is a precursor to having a stroke (warning sign)?

Answer 8

TIA

Question 9

Anoxia and Hypoxia?

Answer 9

Anoxia: total deprivation of O2
Unconscious/dead

Hypoxia: reduced supply of O2
Impaired concentration, STM, new learning & judgement
*Sleep apnoea, chronic obstructive pulmonary disease

Question 10

Lesion:

Answer 10

Discontinuity of brain tissue (almost always loss in fx)

• darker/lighter area (depending on scan)
• demyelination may look similar to lesion on scan

Question 11

Ischemia:

Answer 11

Inadequate blood supply

Question 12

Infarct:

Answer 12

Area of dead cells caused by ischemia

Question 13

Are ischemia and hypoxia the same?

Answer 13

Hypoxia = referring to event (resulting in either semi-perm or permanent cell death)
Ischemia = also inadequate blood supply, but in other contexts too (can refer to both hypoxia and anoxia)

Question 14

Necrosis

Answer 14

Irreversible neuronal cell death
4-6 anoxia
Severe hypoxia (possibility)
8-10 non-severe hypoxia (possibility)

Question 15

How can blood supply be impaired?

Answer 15

Anoxia & hypoxia
Increase ICP suddenly
Blood spilling out of blood vessel (toxins interfere w/ brain metabolism)

Area of brain blood vessel supplies dictates symptoms

Question 16

2 types of hydrocephalus?

Answer 16

1. Communicating: blood mixes with CSF & interferes with reabsorption
2. Obstructive: blocked CSF circulation

Question 17

What causes obstructive hydrocephalus?

Answer 17

Kids - stenosis (artery narrowing)

Adults - tumors infiltrating ventricles

Question 18

Breakdown of CVAs:

Answer 18

TIA - collectively called ischemia: short-lasting insufficient blood supply (no necrosis)
Infarction - severer loss of blood flow (necrosis)
Haemorrhage - bleeding & displacement of brain (more severe - permanent damage/death)

Question 19

Infarcts?

Answer 19

Thrombosis

Embolism

Question 20

Haemorrhages

Answer 20

Intracerebral
Subdural
Aneurysm
AVM

Question 21

Critical distinction between ischemic/haemorrhagic:

Answer 21

Ischemic: blood thinner breaks down clots = blood supply restored
Haemorrhagic: blood thinner = death

Question 22

Symptoms of TIAs:

Answer 22

Motor, sensory or cognitive signs (sudden onset):

• unilateral weakness/tingling in face/limbs
• disorientation
• normal cog. functioning loss (language, visual disturbance)
• normal motor functioning (weakness,slurred speech)

Question 23

Symptoms of anterior TIA?

Answer 23

Brief clumsiness or limb weakness, dysarthria (muscles used for speech are weak = slowed/slurred speech), aphasia

Question 24

Symptoms of posterior TIA?

Answer 24

Dizziness, neglect, double vision, numbness or weakness of extremities

Question 25

Most common cerebral infarction?

Answer 25

Unilateral MCA

Question 26

Blockage of cerebral circulation:

Answer 26

Level of <3: entire brain Carotid artery: anterior & middle cerebral circulation Vertebral artery: posterior circulation

Question 27

Coronary thrombosis?

Answer 27

Heart attack

Question 28

Cerebral thrombosis?

Answer 28

Stroke

Question 29

Lacunar infarction

Answer 29

Due to blockage of very small vessels Deep in brain = usually pure motor & sensory deficits Risk-factors: hypertension & diabetes

Question 30

What is the most common neuropathological process?

Answer 30

Atherosclerosis - build up of fat on artery walls - worse at bifurcation of arteries (common carotid)

Question 31

Thrombosis: why do clots form?

Answer 31

Deviation from normal platelet action

Question 32

Antithrombotic agent?

Answer 32

Asprin

Question 33

Common cause of haemorrhagic CVA?

Answer 33

Rupturing of aneurysm

Question 34

Usually anterior of brain involved:

Answer 34

Embolism | Haemorrhage

Question 35

2 types of haemorrhages

Answer 35

Intracerebral: localized to L/R (defective artery bursts) Subarachnoid: diffuse effects (caused by hypertension/defective blood vessels)

Question 36

Where do about 1/2 aneurysms take place?

Answer 36

Middle carotid artery

Question 37

AVM

Answer 37

Arteriovenous Malformation tangle of abnormal blood vessels, communication between arteries and veins effected therefore abnormal blood flow -headache + vague cognitive complaints -more serious: slow bleeding

Question 38

General Ischemic CVA

Answer 38

``` Feeling strange + collapse with unilateral weakness No H,N,V Focal neurological signs No ICP Tx: blood thinner ```

Question 39

General Haemorrhagic CVA

Answer 39

``` While awake H,N,V Global neurological signs Papilledema (raised ICP) Blood thinners = death ```

Question 40

Left hemisphere

Answer 40

Language & symbolic processing | - Broca's area, Wernicke's area, connections between them

Question 41

Right hemisphere

Answer 41

Visuospatial abilities Rhythmic processing Non-verbal processing

Question 42

Frontal cortex

Answer 42

Motor strip Executive deficits Personality change Emotional change

Question 43

Parietal region

Answer 43

Calculations Symbolic gestures/actions Left/right disorientation

Question 44

Occipital cortex

Answer 44

Visual processing | Object recognition

Question 45

Deep temporal

Answer 45

Episodic memory | Verbal/semantic memory

Question 46

Angiograpgy

Answer 46

Diagnosis of aneurysms, AVMs, artery occlusion, stenosis