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Neurosurgery Resource > Neurovascular > Flashcards

Neurovascular Flashcards

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1
Q

Where does the anterior intracranial circulation originate from?

A

Internal carotid arteries

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2
Q

Where does the posterior intracranial circulation originate from?

A

Vertebral arteries (join to form basilar artery)

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3
Q

What connects the right and left anterior cerebral arteries?

A

Anterior communicating artery

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4
Q

What part of the cerebral hemispheres does the anterior cerebral artery supply?

A

Medial part back to parietal lobe

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5
Q

What does the middle cerebral artery supply?

A

Lateral hemispheres

Basal ganglia

Internal capsule

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6
Q

From which artery does the vertebral artery arise?

A

Subclavian artery

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7
Q

What is the main branch of the vertebral arteries?

A

Posterior inferior cerebellar arteries

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8
Q

The posterior cerebral arteries come off which artery?

A

Basilar artery

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9
Q

What is supplied by the posterior cerebral arteries?

A

Occipital cortex and thalamus

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10
Q

Which arteries connect the anterior and posterior circulations?

A

Posterior communicating artery

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11
Q

Identify the arteries of the circle of Willis

A
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12
Q

What are the two parts of the brain’s venous drainage?

A

Cerebral veins

Dural venous sinuses

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13
Q

What do the dural venous sinuses contain that allow for CSF absorption?

A

Arachnoid granulations

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14
Q

The superior sagittal sinus drains blood into which sinuses?

A

Right and left transverse sinuses

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15
Q

Blood drains from the transverse sinuses into which vein?

A

Internal jugular vein

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16
Q

The superficial cerebral veins drain into which sinus?

A

Superior sagittal sinus

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17
Q

The deep cerebral veins drain into which sinus?

A

Straight sinus

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18
Q

What is an arteriovenous malformation?

A

A complex tangle of arteries and veins connected together with one or more fistulas

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19
Q

What is the commonest feature of an AVM?

A

Haemorrhage

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20
Q

Give some other clinical features of AVMs

A

Seizures

Progressive neurological deficit

Headache

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21
Q

What is the main investigation used for AVMs?

A

Catheter angiography

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22
Q

What investigation is used in an AVM emergency?

A

CTA

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23
Q

How can AVMs be managed?

Study These Flashcards
A

Surgical excision

Stereotactic radiosurgery

Endovascular coiling

24
Q

What occurs in subarachnoid haemorrhage?

Study These Flashcards
A

The presence of blood in the subarachnoid space

25
What is the main cause of an SAH?
Head trauma
26
What is the main cause of non-traumatic SAH?
Berry aneurysm rupture
27
Give some clinical features of SAH
Thunderclap headache Neck stiffness & photophobia N + V Confusion
28
What imaging is used to diagnose an SAH?
CT
29
How is SAH managed?
CT angiography - identifies location and allows for endovascular coiling
30
Give some neurological complications of SAH
Vasospasm Re-bleed Hydrocephalus Seizures Hyponatraemia
31
What is a cavernous malformation?
Well circumscribed benign vascular lesions encompassing sinusoidal spaces
32
Give some clinical features of cavernous malformation
Seizures Progressive neurological deficit Haemorrhage
33
What is the main investigation used for cavernous malformation?
MRI
34
Give some risk factors for cranial aneurysms
Older age Female sex Smoking Hypertension
35
Most aneurysms arise in the anterior/posterior circulation
Anterior
36
Where are the commonest locations for cranial aneursyms?
Junction of anterior communicating artery and anterior cerebral artery Junction of posterior communicating artery and internal carotid
37
What causes a fusiform aneurysm?
Atheromatous degeneration of arterial wall
38
What causes a mycotic aneurysm?
Septic emboli
39
How does a posterior communicating artery aneurysm present?
Third cranial nerve palsy
40
A large anterior communicating artery aneurysm can compress which structure?
Optic chiasm
41
Give some clinical features of basilar aneurysms
Headache Third nerve palsy Confusion Drowsiness
42
How are aneurysms treated?
Endovascular coiling Neurosurgical craniotomy + clipping of aneursymal neck
43
What is a transient ischaemic attack?
Transient obstruction of blood flow to brain, spinal cord or retina
44
Give some risk factors for a TIA
Prior TIA Hypertension AF Diabetes Smoking
45
Give some clinical features of a TIA
Cortical symptoms (facial/limb weakness) Speech abnormalities Visual disturbance CN involvement Memory disturbance
46
What is the main imaging used for TIAs?
MRI
47
What occurs in a cerebral infarction?
Part of the brain loses blood supply due to arterial occlusion
48
What occurs in an intracerebral haemorrhage?
Bleeding from an artery onto the brain tissue from a rupture or leak
49
Give some neurological findings of stroke
Speech disturbance (dysarthia/dysphasia) Contralateral homonymous hemianopia Facial weakness Contralateral limb weakness/sensory loss
50
A total anterior circulation infarct requires all three of what symptoms?
Higher cerebral dysfunction (dysphasia) Homonymous visual field defect Ipsilateral motor and/or sensory deficit
51
What are signs of a partial anterior circulation infarcts?
Two of three of: Higher cerebral dysfunction Homonymous visual field defect Ipsilateral motor/sensory deficit
52
What symptoms can present in a posterior circulation infarct?
Ipsilateral CN palsy + contralateral motor/sensory deficit Bilateral motor/sensory deficit Cerebellar dysfunction Isolated homonymous visual field defect
53
Patients with ischaemic stroke that present within 4.5 hours can be treated with what?
IV alteplase
54
What drug should be started within hours of ischaemic stroke?
Aspirin
55
Patients who have had an ischaemic stroke tend to be on which drug for life?
Clopidogrel

Neurosurgery Resource (5 decks)

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