Flashcards in CNS Part 3 Deck (42)
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1
the most prevalent neurologic disorder in terms of morbidity and mortality.
Cerebrovascular disease
2
3 main categories of cerebrovascular disease
Thrombotic, embolic, hemorrhagic
3
Focal cerebral ischemia follows reduction of blood flow to a ... area that is generally due to an embolus or thrombosis in a large vessel, or vasculitis in medium or small sized vessels.
localized
4
Global cerebral ischemia occurs when there is a ... reduction of cerebral perfusion such as in cardiac arrest and severe sustained hypotension.
generalized
5
Global hypoxia results in ... , which typically occur at the border of areas supplied by the anterior and middle cerebral arteries, and ..., which is related to the short, penetrating vessels.
border zone infarcts; laminar necrosis
6
third leading cause of death and the leading cause of major disability in the United States.
stroke
7
2 main classifications of strokes
ischemic, hemorrhagic
8
Most common type of stroke
ischemic
9
Most debilitating type of stroke
hemorrhagic
10
In the first ..., neurons become vacuolated and eosinophilia of the neuronal cytoplasm occurs (red neurons)
12 to 24 hours
11
After approximately ..., infiltration of a cerebral infarct by neutrophils begins at the edges of the lesion where vascular supply has remained intact.
24 hours
12
Between ... , the infarcted area is characterized by increased numbers of macrophages and surrounding reactive gliosis.
1 and 14 days
13
From ... after a cerebral infarction, necrosis of tissue occurs along with an influx of neutrophils and macrophages.
24 hours to 2 weeks
14
end result of cerebral infarct
reactive proliferation of astrocytes, termed gliosis
15
nonspecific reactive change of glial cells in response to damage to the central nervous system
gliosis
16
This process, which constitutes a form of gliosis known as ... begins within hours of the initial CNS injury
microgliosis
17
Later, approximately 3–5 days after the initiating event, ... , precursor cells, are also recruited to the site and may contribute to remyelination.
oligodendrocytes
18
The final component of gliosis is ... , the proliferation of surrounding astrocytes, which are the main constituents of the glial scar.
astrogliosis
19
Macroscopic examination of the brain may reveal diffuse edema with narrowed sulci and widened gyri
cerebral infarction
20
Neurons are the most sensitive of all cell types to anoxic injury. Seen here are red neurons which are dying neurons as a result of sustained hypoxia.
red neurons
21
Gliosis, both within and around the infarct, is evident most prominently at what time?
by the second week
22
most common cause of thrombotic occlusion
Atherosclerosis
23
Most frequently, the vessel found to have the greatest degree of compromise in ischemic stroke
middle cerebral artery.
24
Complete occlusion of a cerebral vessel is frequently preceded by fleeting and transient neurologic symptoms
Transient ischemic attacks
25
TIAs are important to recognize because they may be clinical markers for an increased
risk of subsequent cerebral infarction.
26
Valvular vegetations in S.B.E. and thrombi in the auricular appendages, often associated with ... , can also embolize to the brain.
atrial fibrillation
27
is the primary underlying cause of most cases of intracerebral hemorrhage.
hypertension
28
Cerebellar and brainstem stokes generally occur as a result of pathology in the ... arteries
vertebral or basilar
29
The most frequent cause of clinically signifigant subarachnoid hemorrhage is the
rupture of a berry (saccular) aneurysm.
30
thin wall out-pouching from an area on the circle of Willis
berry aneurysm
31
the most common type of clinically significant vascular malformation.
Arteriovenous malformations
32
In macroscopic appearance, they resemble a tangled network of wormlike vascular channels and have a prominent, pulsatile arteriovenous shunt with high blood flow through the malformation.
AVMs
33
Petechiae and fibrinoid necrosis of arterioles in the gray and white matter may be seen microscopically
Hypertensive encephalopathy
34
the most common type of skull fracture
linear
35
linear fractures that cause the bones of the skull to separate at the skull sutures in young children whose skull bones have not yet fused.
Diastatic skull fractures
36
those in which a bone is shattered into many pieces, can result in bits of bone being driven into the brain.
Comminuted skull fractures
37
mastoid ecchymosis = suspect basilar skull fracture
battle's sign
38
bilateral periorbital ecchymosis = if patient unconscious or with hx of head trauma suspect basilar skull fracture
raccoon's eyes
39
Vessels within the dura, most importantly the ... artery, are vulnerable to injury, particularly with skull fractures.
middle meningeal
40
may occur as a result of the rupture of a meningeal artery, usually associated with a skull fracture
epidural hematoma
41
A fracture that lacerates either the ... or a ... is present in 85-95% of patients with epidural hematomas.
middle meningeal artery (MMA); dural venous sinus
42
