Nervous Damage 2

Question 1

what are the 4 causes of ischaemic stroke?

Answer 1

atherothrombotic cerebrovascular disease, cryptogenic so no cause, lacunar

Question 2

what is atherothrombotic cerebrovascular disease?

Answer 2

blockage of the blood supply to the brain

Question 3

what is lacunar cause of ischaemic stroke?

Answer 3

small vessel disease

Question 4

what are the 2 types of haemorrhagic stroke?

Answer 4

intercerebral or subarachnoid

Question 5

how is anatomical Protection of the brain caused?

Answer 5

by the circle of Willis

Question 6

what are the 4 vessels that supply circle of willis?

Answer 6

left and right internal carotid and left and right vertebral

Question 7

what arteries come out of the circle of willis?

Answer 7

anterior, middle and posterior cerebral arteries

Question 8

what is the function of the arteries coming out of circle of willis?

Answer 8

supply distinct areas of the brain

Question 9

where is supplied by the middle cerebral arteries?

Answer 9

lateral regions of the brain

Question 10

what are the modifiable risks of strokes?

Answer 10

smoking, diabetes, high blood pressure, obesity, arrhythmia, drug abuse, alcohol abuse

Question 11

what are the non-modifiable risk factors of strokes?

Answer 11

age, genetics, race, prior strokes, gender

Question 12

how does a intracerebral haemorrhage begin?

Answer 12

vessel rupture leads to extravasation of blood into the brain parenchyma

Question 13

how does a intracerebral haemorrhage grow?

Answer 13

the initial haemotoma causes an increase in local pressure and rupture of other vessels

Question 14

how might intracerebral haemorrhages be more likely to happen?

Answer 14

coagulation disorders causes a higher bleed and higher blood pressure may mean re-bleeding may occur

Question 15

how does a subarachnoid haemorrhage occur?

Answer 15

rupture of saccular anaeuryms in the vessels that supply the brain

Question 16

where do subarachnoid haemorrhages usually occur?

Answer 16

in the circle of willis where bifurcations of major arteries are located

Question 17

what is a flaw in the circle of willis?

Answer 17

high number of junctions and so likely to form aneurysms

Question 18

what is grade I of intracranial aneurysms?

Answer 18

asymptomatic or a minimal headache

Question 19

what is grade II of intacranial aneurysm?

Answer 19

headache and moderate neck rigidity

Question 20

what is grade III of intracranial haemorrhage?

Answer 20

drowsiness, confusion, mild focal deficit

Question 21

what is grade IV intracranial haemorrhage?

Answer 21

stupor, moderate to severe hemi paresis, early decerebrate rigidity

Question 22

what is grade V of intracranial haemorrhage?

Answer 22

deep coma, decerebrate rigidity

Question 23

how are haemorrhagic strokes diagnosed?

Answer 23

thunderclap headaches, xanthochromic lumbar, star pattern on CT scan

Question 24

how can aneurysms be treated?

Answer 24

prevented bursting by clipping aneurysm or using an endovascular coil to prevent blood clotting

Question 25

what types of strokes are most common?

Answer 25

ischaemic stroke

Question 26

what makes ischameia so damaging to the brain?

Answer 26

high vascular supply, high cellular activities, cell type variations

Question 27

at what time does blood deprivation to the brain become permanent?

Answer 27

4 minutes

Question 28

what is the ischaemic core?

Answer 28

area most affected by ischaemic event such as low oxygen, low ATP and glucose and low pH

Question 29

what area of the brain is less affected by ischaemia?

Answer 29

penumbra

Question 30

what is the left hemisphere responsible for?

Answer 30

mathematical and scientific functions

Question 31

what is the right hemisphere responsible for?

Answer 31

more artistic and creative functions

Question 32

what kind of stress can happen in the brain?

Answer 32

oxidative, mechanical or metabolic

Question 33

how can higher levels of calcium be caused by stress?

Answer 33

stress can reduce the concentration of ion pumps, cause membrane damage and release calcium stores from mitochondria

Question 34

what damaging effects happen due to increased calcium?

Answer 34

activate unwanted enzymes, disruption to cytoskeleton, cell dysfunction or apoptosis and membrane blobbing

Question 35

what is an ischaemic cascade?

Answer 35

lack of blood flow causes ischaemia, impacts pre and post synaptic cells, causes decreased energy of cells and eventually neurones death

Question 36

what things can cause epilepsy?

Answer 36

electrolyte imbalance, fever, hypoglycaemia, hypoxia, brain tumours, brain injury

Question 37

what is grand Mal?

Answer 37

tonic-clonal seizures

Question 38

what is petit mal?

Answer 38

absence seizures with a brief change in consciousness

Question 39

what things can trigger seizures?

Answer 39

infections, trauma, drugs, electrolyte imbalance, tumours or strokes, fevers

Question 40

what are the key features of epilepsy diagnosis?

Answer 40

that a normal EEG or an abnormal EEG is not sufficient for diagnosis

Question 41

what are the dangers of seizures?

Answer 41

chance of injury and brain cells can die

Question 42

what is excitotioxicity?

Answer 42

brain cell death during a seizure

Question 43

how does excitotoxicity occur?

Answer 43

seizures release glutamate, activation of glutamate NDMA receptors, the double gating system is opened, magnesium ion block is removed and calcium enters mediating neuronal damage

Question 44

what things effect treatment of epilepsy?

Answer 44

pre-existing conditions, dosage and monitoring and type of syndrome