Neuropathology of Cerebrovascular Disease Flashcards Preview

Pathology > Neuropathology of Cerebrovascular Disease > Flashcards

Flashcards in Neuropathology of Cerebrovascular Disease Deck (29):
1

What is the source of anterior flow in the brain?

Internal Carotid ~70% of CBF

2

What is the source of posterior flow in the brain?

Vertebral Arteries 30% of CBF

3

What is the order of cells in the CNS from most to least sensitive to ischemia?

neurons > oligodendrocytes > endothelial cells > astrocytes

4

What changes appear 6-12 hours after global cerebral ischemia?

Red Neurons

5

What are areas that are very vulnerable to ischemia?

-􏰀 Pyramidal neurons in cerebral cortex (layers 3, 5 and 6) – leads to LAMINAR NECROSIS
-􏰀 Pyramidal neurons of hippocampus (long term memory)
􏰀- Purkinje cells of cerebellum

6

What artery feeds the lateral areas of the brain?

MCA

7

What artery feeds the superio-medial area of the brain?

ACA

8

What artery feeds the inferio-medial area of the brain?

PCA

9

What are the main causes of small vessel disease in the CNS?

- HTN
- Diabetes
- Vasculitis

10

What is the cause of thrombotic strokes?

Rupture of atherosclerotic plaque

11

What is the cause of embolic strokes?

Cardioembolism often from atrial fibrillation

12

What vessels does lacunar stroke affect?

Lenticulostriate Vessels

13

What is the most common artery involved in embolic infarct?

MCA

14

What can be seen with lacunar strokes?

Arterial Hyalinosis from Hyaline Arteriolosclerosis as a result of HTN

15

Hypertensive Hemorrhage

‐ Circumscribed hematoma surrounded by brain tissue
‐ Hemorrhage may extend into the subarachnoid space or to the ventricles

16

Subarachnoid Hemorrhage

Bleeding into subarachnoid space

17

What is the most common cause of subarachnoid hemorrhage?

Berry Aneurysm

18

What are the associations of Berry aneurysms?

- Female
- AD Polycystic Kidney Disease
- Ehrler-Danos
- Marfan's Syndrome

19

Where are most Berry aneurysms found?

Anterior Communicating Artery in the Circle of Willis

20

Intraventricular Hemorrhage

Rare in adults but common in premature infants with massive intraventricular hemorrhages being instantaneously fatal

21

Duret Hemorrhage

They are small lineal areas of bleeding in the midbrain and upper pons of the brainstem. They are caused by a traumatic downward displacement of the brainstem.

22

Epidural Hematoma

Blood between dura and the skull - often due to rupture of the middle meningeal artery

23

Subdural Hematoma

Blood underneath the dura covering brain surface - due to tearing of bridging veins

24

What can tonsillar herniation lead to the compression of?

Compression of the brainstem which can lead to cardiopulmonary arrest

25

What can subfalcine herniation lead to the compression of?

Compression of ACA leads to infarction

26

What can uncal herniation lead to the compression of?

- CN III - eye will go down and out and dilate
- PCA which causes occipital lobe infarction
- Rupture of the paramedian arteries leading to Duret hemorrhages

27

Tonsillar Herniation

Downward displacement of cerebellar tonsils into foramen magnum

28

Subfalcine Herniation

Displacement of the cingulate gyrus under falx cerebri

29

Uncal Herniation

Displacement of the uncus of the temporal lobe under the tentorium cerebelli

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