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Jason's Neuro Block > Stroke > Flashcards

Flashcards in Stroke Deck (37):
1

Stroke is development of what two neurologic deficit related to vascular event?

focal or global

2

2 kinds of atypical strokes?

1. transient
2. 'silent'

3

Strokes are:
75%
20%
5%

75% Infarction
20% Haemorrhage
5% Subarachnoid (younger people)

4

stroke risk factors: 7 bigs

aging
hypertension
cardiac disease
hyperlipid
DMII
hypercoagulability
smoking/obesity

5

Definition of cerebral infarction?

necrosis due to occlusion or hypoperfusion

6

what vascular structures usually cause of cerebral infarction?

usually arterial
arterioles, veins, heart

7

3 main mechanisms of cerebral infarction

1. pump failure
2. narrowed lumen
3. emboli occlusion

8

causes of narrowed lumen in cerebral infarction? 3 things:

1. atherosclerosis
2. thrombosis
3. hypertensive thickening

9

what is usual cause of large artery occlusions?

embolic

10

what is usual cause of small vessel occlusions?

thrombosis

11

what is usual cause of venous occlusions?

thrombotic

12

what can happen in heart valves to cause stroke? causes?

valve vegetations due to:
1. infectious
2. non-infectious deformities

13

1/3 of population has what in their heart that will increase stroke risk?

1. patent interatrial septum
2. allows DVTs to pass into brain and skip lungs

14

Common sites for atherosclerosis in circle of willis? 4 areas

vertebral artery
internal carotid
proximal MCA
basilar

15

when brain tissue is injured, what happens to area around it?

cytotoxic oedema>increased ICP>herniations (subfalcine or uncal)

16

dead neurons histologically look?

surrounded by anoxic-ischemic neurons

17

after swelling recedes in cerebral infarct, what happens to the dead area?

liquidative necrosis>cystic space

18

what are cerebral haemorrhagic infarcts?

from reperfusion damage, and can come from cardiac ventricle thrombus/emboli

19

berry aneurysm cause usually?

hypertension causing hyaline arteriolosclerosis

20

lacunar infarcts are? dangerous where?

small infarcts from hypertension, can be devastating if in brainstem

21

people with cerebral infarcts die how? top 3:

Usually sequelae

1. pneumonia
2. cardiovascular disease
3. pulmonary thromboembolism (immobility)

22

hypertensive small vessel disease affects which vessels?

deep structures

23

congophilic (amyloid) angiopathy affects which vessels?

superficial periphery of brain

24

hypertensive haemorrhage usually has what disease?

hyaline arteriolosclerosis

25

hypertensive haemorrhage usually happens where? 4 places

basal ganglia/thalamus
lobar white matter
cerebellum
pons

26

high pressure cerebral haemorrhage does what?

tear through neural tissue

27

low pressure cerebral haemorrhage does what?

ooze and then separate cerebral tissue

28

cerebral amyloid angiopathy has deposition of what? which vessels?

A beta-amyloid plaques in wals of superficial supratentorial blood vessels

29

cerebral amyloid angiopathy has association with?

alzheimer's disease

30

when do you get multifocal synchronous haemorrhages?

coagulopathy, blood disorders (leukaemia)

31

congenital ateriovenous malformation does what?

high pressure arteries join to low pressure veins without crossing capillaries = haemorrhage

32

3 causes of subarachnoid haemorrhage?

1. berry aneurysm rupture
2. other aneurysm rupture (mycotic/atherosclerotic)
3. extension of intracerebral haemorrhage

33

who is more at risk for devloping saccular aneurysm?

women
younger

34

risk factors for saccular aneurysm? 5 things

1. polycystic kidney disease
2. coarctation of aorta
3. type III collagen deficiency
4. hypertension
5. smoking/alcohol

35

saccular aneurysms occur which circulation?

90% anterior circulation
10% posterior

36

3 places that saccular aneurysms like to form?

1. bi-trifurcation of MCA
2. junction of ICA/PCOM
3. ACOM

37

4 complications of aneurysm rupture

1. subarachnoid haemorrhage
2. increase ICP/cerebral oedema
3. vasospasm/infarction
4. ventricular obstruction>hydrocephalus