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Jason's Neuro Block > Stroke > Flashcards

Flashcards in Stroke Deck (37)
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1
Q

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

A

focal or global

2
Q

2 kinds of atypical strokes?

A
  1. transient

2. ‘silent’

3
Q

Strokes are:
75%
20%
5%

A

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

4
Q

stroke risk factors: 7 bigs

A
aging
hypertension
cardiac disease
hyperlipid
DMII
hypercoagulability
smoking/obesity
5
Q

Definition of cerebral infarction?

A

necrosis due to occlusion or hypoperfusion

6
Q

what vascular structures usually cause of cerebral infarction?

A

usually arterial

arterioles, veins, heart

7
Q

3 main mechanisms of cerebral infarction

A
  1. pump failure
  2. narrowed lumen
  3. emboli occlusion
8
Q

causes of narrowed lumen in cerebral infarction? 3 things:

A
  1. atherosclerosis
  2. thrombosis
  3. hypertensive thickening
9
Q

what is usual cause of large artery occlusions?

A

embolic

10
Q

what is usual cause of small vessel occlusions?

A

thrombosis

11
Q

what is usual cause of venous occlusions?

A

thrombotic

12
Q

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

A

valve vegetations due to:

  1. infectious
  2. non-infectious deformities
13
Q

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

A
  1. patent interatrial septum

2. allows DVTs to pass into brain and skip lungs

14
Q

Common sites for atherosclerosis in circle of willis? 4 areas

A

vertebral artery
internal carotid
proximal MCA
basilar

15
Q

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

A

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

16
Q

dead neurons histologically look?

A

surrounded by anoxic-ischemic neurons

17
Q

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

A

liquidative necrosis>cystic space

18
Q

what are cerebral haemorrhagic infarcts?

A

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

19
Q

berry aneurysm cause usually?

A

hypertension causing hyaline arteriolosclerosis

20
Q

lacunar infarcts are? dangerous where?

A

small infarcts from hypertension, can be devastating if in brainstem

21
Q

people with cerebral infarcts die how? top 3:

A

Usually sequelae

  1. pneumonia
  2. cardiovascular disease
  3. pulmonary thromboembolism (immobility)
22
Q

hypertensive small vessel disease affects which vessels?

A

deep structures

23
Q

congophilic (amyloid) angiopathy affects which vessels?

A

superficial periphery of brain

24
Q

hypertensive haemorrhage usually has what disease?

A

hyaline arteriolosclerosis

25
Q

hypertensive haemorrhage usually happens where? 4 places

A

basal ganglia/thalamus
lobar white matter
cerebellum
pons

26
Q

high pressure cerebral haemorrhage does what?

A

tear through neural tissue

27
Q

low pressure cerebral haemorrhage does what?

A

ooze and then separate cerebral tissue

28
Q

cerebral amyloid angiopathy has deposition of what? which vessels?

A

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

29
Q

cerebral amyloid angiopathy has association with?

A

alzheimer’s disease

30
Q

when do you get multifocal synchronous haemorrhages?

A

coagulopathy, blood disorders (leukaemia)

31
Q

congenital ateriovenous malformation does what?

A

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

32
Q

3 causes of subarachnoid haemorrhage?

A
  1. berry aneurysm rupture
  2. other aneurysm rupture (mycotic/atherosclerotic)
  3. extension of intracerebral haemorrhage
33
Q

who is more at risk for devloping saccular aneurysm?

A

women

younger

34
Q

risk factors for saccular aneurysm? 5 things

A
  1. polycystic kidney disease
  2. coarctation of aorta
  3. type III collagen deficiency
  4. hypertension
  5. smoking/alcohol
35
Q

saccular aneurysms occur which circulation?

A

90% anterior circulation

10% posterior

36
Q

3 places that saccular aneurysms like to form?

A
  1. bi-trifurcation of MCA
  2. junction of ICA/PCOM
  3. ACOM
37
Q

4 complications of aneurysm rupture

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