cerebrovascular disease

Question 1

85% of cases are _________ and 15% are _______?

Answer 1

85 - ischemic

15 - hemorrhagic

Question 2

acute onset of neurologic symptoms?

Answer 2

STROKE

Question 3

reduction of cerebral perfusion

chronic hypox/hypoglycemia

Answer 3

global ischemai

Question 4

mild global ischemia

Answer 4

transient confusion/recovery

Question 5

moderate global ischemai

Answer 5

infarction of watershed damaging vulnerable areas
pyramindal neurons of cereb cortex and hippo
purkinje fibers of cerebellum

Question 6

severe global ischemia

Answer 6

diffuse necrossi –>vegetative state (flat encephalogram; irreversible)

Question 7

RED neurons - neuron death form acute irrev hypoxic insult
cell body shrink, nuc pyknosis, loss of Nissle, cyto eosinophilia
neut infiltrations

Answer 7

early morphological changes (12-24hrs) of global ischemia

Question 8

tissue necrosis, MAC, vasc prolif, reactive gliosis

hyperplasia and hypertrophy of astrocytes - restore CSF BBB, init inflamm and reactive scar formation

Answer 8

subacute morph changes (24hr - 2wks) of global ischemia

Question 9

necrotic tissue replaced by gliosis with loss of normal organization
necrossis of susceptible layera dn preservation of others
highest vuln cell - pyramidal cell CA1, neocort layers (3,5, 6) and purkinj cells

Answer 9

repaid morph (after 2wk) of global ischemia

Question 10

bilateral hippocampal damage causes…..?

inability to retain new info (anterograde amnesia ) and less severe retrograde amnesia

Answer 10

KorsaKoff’s amnesia

Question 11

focal neuro deficit lasting <24 hrs

Answer 11

TIA

Question 12

permanet irrev cerebral infarct

Answer 12

stroke

Question 13

most common kind of stroke?

Answer 13

thrombotic

Question 14

type of stroke, cuased by atherosclerosis, typical at carotid bifur, MCA, or basilar art, risk factors: HTN & DM

Answer 14

thrombotic stroke

Question 15

type of stroke, most commonly caused by mural thrombi from Left heart post MI/Afibb/valv dz, and sometimes athero plaque, paradox emboli, tumor, Often involves MCA

Answer 15

embolic stroke

Question 16

morph: hemorrhagic infarcts** due to reperfusion of inn vessesl after dissolution of plaque

Answer 16

embolic stroke

Question 17

morph: nonhemorrhagic plaques = PALE infarct

Answer 17

thrombotic stoke

Question 18

appearance of red neurons and edema in morph?

Answer 18

12 hrs

Question 19

coag necrosis on morph?

Answer 19

24hrs

Question 20

neut infiltration on morph?

Answer 20

1-3 days

Question 21

microglial infiltration on morph

Answer 21

4-7days

Question 22

granulation tissue formation on morph?

Answer 22

2 weeks

Question 23

phagocytosis and formation of fluid filled cytic space surround by reactive gliosis on morph?

Answer 23

3+ weeks

Question 24

HTN, cerebral amyloid angiopathy, ruptured arterial aneurysms, and vascular malformations are major causes of ___________?

Answer 24

intracerebral hemorrhage!!!

Question 25

charcot bouchard microaneurysms slit hemmorrhage lacunar infarcts acute hypertensive encephalopathy these all define....?

Answer 25

hypertensive cerebrovascular dz

Question 26

small noncortical infarcts caused by occulsion of penetrating bra of large cerebral artery - lake like appearance

Answer 26

lacunar infarcts

Question 27

inc ICP due to elev DBP >130mmHg

Answer 27

acute hypertensive enceph

Question 28

fibrinoid necrosis and thrombosis of arterioles and capillaries

Answer 28

microinfarcts and micro hemorrhages due to MALIGNANT HYPERTENSION

Question 29

2ND MOST COMMON CAUSE of parenchymal brain hemorrhage

Answer 29

cerebral amyloid angiopathy

Question 30

-insol 8-10nm thick amyloid fibrils in arteries ischemic lesions - microinfarcts - leukoencphalopathy hemorrhagic lesions - micro bleed with lobar distribution (NOT IN THALAMUS/BG)

Answer 30

CEREBRAL AMYLOID ANGIOPATHY

Question 31

MOST COMMON aneurysm of brain?

Answer 31

intracranial berry aneurysm

Question 32

most common cause of subarachnoid hemorrhage?

Answer 32

berry aneurysm

Question 33

absence of tunica ________ and _________ at bifurications cause berry aneurysms?

Answer 33

media and elastic lamina

Question 34

most common diseases assoc with berry aneurysm??

Answer 34

marfans, polycystic kidney disease (APKD)

Question 35

risk factors for berry aneurysm?

Answer 35

smoking and HTN

Question 36

most common type of vasc malformation?

Answer 36

AVMs

Question 37

affects M or F more? age range? for vasc malformations...

Answer 37

M>>F | 10-30 y/o

Question 38

presentation: siezures, intracerebral/subarachnoid hemorrhage telangiectasia may be present with mult AVM

Answer 38

vasc malformation