Cerebrovascular Disease Flashcards Preview

Neuro > Cerebrovascular Disease > Flashcards

Flashcards in Cerebrovascular Disease Deck (25)
Loading flashcards...
1

Where do intraparenchymal hemorrhages occur?

1) Basal ganglia (MOST common)
2) Internal capsule

2

What causes intraparenchymal hemorrhages?

Systemic HTN, Charcot-Bouchard aneurysm of lenticulostriate vessels

3

What are the 2 most vulnerable regions of brain to ischemia?

Hippocampus (pyramidal cells in layers 3, 5, 6) and Purkinje cells of cerebellum

4

When is irreversible damage to the brain after hypoxia seen?

5 mins

5

2 types of strokes?

Ischemic and hemorrhagic

6

2 types of ischemic strokes?

Global and focal cerebral ischemia

7

What causes global ischemia?

1) Atherosclerosis
2) Hypotension (shock)
3) Chronic hypoxia (anemia)
4) Repeated episodes of hypoglycemia (insulinoma)

8

What occurs after 5-10 secs of cessation of cerebral blood supply?

LOC (syncope)

9

What occurs after 1 min of cessation of cerebral blood supply?

Cessation of neural activity

10

Where is cortical laminar necrosis seen?

Moderate global ischemia

11

What are 3 causes of focal ischemia?

1) Thrombotic
2) Embolic
3) Lacunar

12

What is an ischemic stroke?

Regional ischemia that results in focal neurologic deficits for >24 hrs

13

What is a transient ischemic attack?

Brief reversible episode of focal neuro dysfunction with sxs lasting <24 hrs

14

Where do you see a pale infarction at the periphery of the cortex?

Thrombotic stroke

15

Where do you see hemorrhagic infarction at periphery of cortex?

Embolic stroke

16

What are thrombotic strokes due to?

Ruptured plaque due to atherosclerosis

17

What are embolic strokes due to?

A-fib, usually involves MCA

18

What are lacunar strokes due to?

Secondary to hyaline arteriolosclerosis (HTN, DM) affecting the lenticostriate arteries)

19

What is seen after 12-48 hrs?

Red neurons

20

What is seen after 24-72 hours?

Neutrophils + necrosis

21

What is seen after 3-5 days?

Macrophages that light up with oil red O

22

What is seen after 1-2 weeks?

Reactive gliosis + vascular proliferation

23

What is seen after >2 weeks?

Glial scar

24

How do you treat ischemic strokes?

tPA within 4.5 hrs (as long as pt presents within 3 hrs of onset and there is no major risk of hemorrhage)

25

When is tPA contraindicated?

Bright areas on noncontrast CT indicating hemorrhage