Flashcards in Neuro V Deck (60)
Most common site of berry aneurysm
Junction of anterior communicating and ACA.
berry aneurysm RF's
1) advanced age
4) race (increased risk in blacks)
Locations of charcot-bouchard aneurysms
Micro aneurysms in basal ganglia + thalamus
Imaging and charcot-bouchard aneurysms
They're too small to see on angiograms.
Etiology of charcot-bouchard aneurysms
Complications of ACA berry aneurysms?
1) compression of ACA can lead to bitemporal hemianopia; visual acuity deficits.
2) ACA rupture can lead to lower extremity hemiparesis, sensory deficits.
Complications of PCA berry aneurysms?
Compression may cause CN III palsy (blown pupil).
Complications of MCA berry aneurysms?
Rupture may cause ischemia in MCA distribution --> contralateral upper extremity and facial hemiparesis, sensory deficits.
What is central post-stroke pain syndrome? Presentation? Epidemiology?
1) Neuropathic pain due to thalamic lesions.
2) Initial paresthesias followed in weeks to months by allodynia (ordinarily painless stimuli cause pain) and dysesthesia.
3) happens to 10% of stroke patients.
Epidural hematomas due too.
middle meningeal artery rupture
middle meningeal branches from...
Epidurals and suture lines?
DO NOT cross
often secondary to skull fracture
Rapid expansion under systemic arterial pressure can lead to transtentorial herniation + CN III palsy.
Subdural hematoma etiology...
ruptured bridging veins
Chronic vs acute subdural on CT
1) acute (traumatic, high-energy impact) --> hyper dense on CT
2) Chronic --> hypodense on CT
Subdurals seen in..
1) mild trauma or high-energy trauma
2) cerebral atrophy
5) shaken babies
Subdurals and suture lines?
Cross suture lines.
Impt clinical finding for subarachnoid hemorrhage
bloody or yellow (xanthochromic) spinal tap.
When does vasospasm occur?
4-10 days after subarachnoid
Other impt subarachnoid sequela...
Communicating and/or obstructive hydrocephalus.
Intraparenchymal hemorrhage caused by...
1) most commonly systemic HTN
2) amyloid angiopathy
5) secondary to repercussion injury in ischemic stroke.
Location of intraparenchymal hemorrhage...
Typically basal ganglia + internal capsule but can be lobar.
Charcot-Bouchard and intraparenchymal hemorrhage
Rupture charcot-bouchard in lenticulostriate vessels in internal capsule can cause intraparenchymal hemorrhage.
When does irreversible damage occur after a stroke?
5 minutes of hypoxia
Most vulnerable brain regions to ischemic stroke
4) watershed areas
1) get imaging: Noncontrast CT to exclude hemorrhage
When can CT detect ischemic changes?