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TERM 3 BIOL2292 PATHO 2 > NEURO 1: BRAIN INJURY & STROKE > Flashcards

NEURO 1: BRAIN INJURY & STROKE Flashcards

1
Q

Name 4 mechanisms that cause acute brain injury

A
  1. Ischemia & hypoxia
  2. Excitotoxins
  3. Reperfusion injury
  4. Abnormal autoregulation of blood flow
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2
Q

Why is the brain so sensitive to decreased perfusion?

A

Has low glycogen stores and low capacity for anaerobic metabolism

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3
Q

How long does the brain need to be deprived of oxygen to cause irreversible damage?

A

5-10 minutes

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4
Q

What is the main excitatory amino acid neurotransmitter that can cause excitotoxic effects?

A

Glutamate

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5
Q

What are 2 reasons why there may be excess glutamate in the brain?

A
  1. Cell membrane damage causing excess glutamate release
  2. Lack of ATP being made causing impaired glutamate reuptake
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6
Q

How does excess glutamate cause cell damage?

A

It binds to cell receptors that allow calcium and water entry into the cell causing cell swelling

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7
Q

What are 4 ways reperfusion can cause further damage to brain tissue?

A
  1. Reactive oxygen species
  2. Invasion of immune cells causing inflammation
  3. Compromised blood-brain barrier
  4. Platelet aggregation
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8
Q

If blood flow to the brain shows an impaired ability vasodilate (e.g. thrombosis, vasospasm, neutrophil aggregation), what is the end result?

A

Ischemia

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9
Q

If blood flow to the brain shows an impaired ability to vasoconstrict (e.g. vascular injury), what is the end result?

A

Hyperperfusion and edema

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10
Q

Which part of the Glasgow coma scale is the best predictor of patient outcomes following brain injury?

A

Motor response

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11
Q

What is the term for an abnormal flexion response to pain?

A

Decorticate posturing

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12
Q

What is the term for an abnormal extension response to pain?

A

Decerebrate posturing

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13
Q

What is the term for an abnormal persistent rhythmic/jerky movement of the eyes?

A

Nystagmus

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14
Q

What is the term for eyes not moving in the same direction?

A

Dysconjugate movement

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15
Q

What is the term for paralysis of the eye muscles?

A

Ocular palsy

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16
Q

What is the proper term for “doll eyes?”

A

Abnormal oculovestibular reflex

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17
Q

What is the proper term for the blink response?

A

Corneal reflex

18
Q

What are 3 kinds of primary traumatic brain injury based on location?

A
  1. Focal (coup)
  2. Polar (coup-contrecoup)
  3. Diffuse
19
Q

What are 3 kinds of primary TBI based on severity of injury?

A
  1. Concussion (altered LOC but no damage)
  2. Contusion (tissue damage present)
  3. Intracranial hematoma (bleed)
20
Q

What are 3 types of intracranial hematoma based on compartment?

A
  1. Epidural
  2. Subdural
  3. Subarachnoid
21
Q

What may cause an epidural hematoma?

A

Rupture of meningeal artery

22
Q

What is the typical presentation of an epidural hematoma?

A
  1. Decreased LOC
  2. “Lucid interval”
  3. Rapid deterioration
23
Q

What may cause a subdural hematoma?

A

Damage to bridging veins

24
Q

How are the symptoms of subdural hematoma different from epidural hematoma?

A

May have a slower onset (e.g. subacute type shows symptoms 2-10 days later)

25
Q

Why may a subdural hematoma become chronic?

A

After healing, granulation tissue is more fragile

26
Q

What may cause a subarachnoid hematoma?

A

Rupture of cerebral aneurysm or AVM

27
Q

What causes symptoms of subarachnoid hematoma like meningeal irritation, hydrocephalus, and ischemia?

A

Blood spreads through CSF

28
Q

What does the acronym BEFAST stand for?

A

Balance (loss of balance, headache, dizziness)

Eyes (blurred vision)

Face (drooping)

Arms (weakness, esp. one sided)

Speech (difficulty)

Time (call 911 immediately)

29
Q

What is the most common type of stroke?

A

Ischemic

30
Q

What are 2 risk factors for thrombotic stroke?

A

Atherosclerosis

Coagulative disorders

31
Q

What are 2 risk factors for embolic stroke?

A

Cardiac dysfunction

Cardiac dysrhythmia

32
Q

In stroke patients, what is the term for the region of cells in the brain surrounding an ischemic core that still receive partial blood flow and may still be viable?

A

Penumbra

33
Q

What is the term for a procedure to remove plaque from an artery to restore bloodflow?

A

Endarterectomy

34
Q

What is the term for a procedure to open up an artery using a ballon or stent?

A

Angioplasty

35
Q

Why should a transient ischemic attack be considered serious even if symptoms completely resolve?

A

About 1/3 of strokes are preceded by a TIA

36
Q

What are 2 kinds of hemorrhagic stroke?

A
  1. Intracerebral hemorrhage (bleeding into brain parenchyma)
  2. Subarachnoid hemorrhage (bleeding into subarachnoid space–between arachnoid and pia)
37
Q

What are 2 cardiac related risk factors for hemorrhagic stroke?

A
  1. Hypertension
  2. Use of anticoagulants
38
Q

What are 4 ways a hemorrhagic stroke damages the brain?

A
  1. Compression injury to surrounding tissue
  2. Cuts off blood supply causing ischemia
  3. Direct toxic effects from bleed on brain tissue and vasculature
  4. Inflammation
39
Q

How do the symptoms of hemorrhagic stroke differ from ischemic stroke?

A

The present in the same way, so imaging is required to determine the cause

40
Q

In what way is the pharmacological management of ischemic and hemorrhagic stroke different?

A

Ischemic stroke: trying to break up the clot by using thrombolytics and anticoagulants

Hemorrhagic stroke: trying to encourage clotting to stop the bleeding by using reverse anticoagulants

TERM 3 BIOL2292 PATHO 2 (19 decks)

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