Vascular Diseases Flashcards
(40 cards)
Stroke caused by (6)
Atrial fib Atherosclerosis High BP Vasospasm FMD Radiation induced vasculopathy
Underlying condition of ISCHEMIC STROKE (1) OBSTRUCTION types (2)
Atherosclerosis
- central thrombosis (blood clot in brain)
- central embolism (blood clot breaks loose)
VASOSPASM
- what is it
- what is it associated with (in what time frame)
A blood vessel that contracts causing less blood flow
4-10 days after a subarachnoid hemorrhage
Arteriovenous malformation (AVM)
- what is it
- m/f dominance
- symptoms
An abnormal connection between arteries and veins, bypassing the capillary system
Bypasses normal brain tissue
Diverts blood from the arteries to the veins
- male predominance
- (20-25%) focal/generalized seizures, (15%) difficulty with movement, speech, vision
ANEURYSM CEREBRAL
- risk factors (2)
- m/f dominance
- complications (4)
RF: hypertension, drug abuse (alcohol, coke, smoking)
Female predominance
Complications: (serious: hemorrhagic stroke, permanent nerve damage, death) or a subarachnoid hemorrhage
What can ATRIAL FIBRILLATION cause? How? What can this lead to?
Atrial fib, (irregular heart beat) can cause cardiac thrombus
Blood pools in the atria and is not completely pumped into the ventricles - causes thrombus
Thus the source of emboli (in 1/4 pts)
T/F A. FIBRILLATION is the most common type of arrhythmia
True
LEFT VENTRICULAR DYSFUNCTION / CHF is associated with increased risk of (2) which can lead to _____
What is the treatment?
Thrombus formation
Stroke
Lead to Embolism
Tx: anti-coagulation therapy
CARDIAC THROMBUS - right heart indication
Doubles mortality up to 29%, requires more aggressive tx (embollectomy / lyric therapy)
Cardiac thrombi may be seen following (4)
Ventricular dysfunction
Cardiomyopathy
Myocardial infarction
Ventricular aneurysm
Non-atherosclerotic vascular disease (8)
Dissection Arteriovenous fistula (AVF) Fibromuscular disease (FMD) Takayasu’s arteritis Pseudoaneurysm Giant cell arteritis Buerger’s disease
What is the most common cause of STROKE in YOUNG ADULTS
Carotid artery dissection
CAROTID ARTERY DISSECTION - where does it ORIGINATE and EXTEND
Aortic arch, extends into the bifurcation
DISSECTION-SPONTANEOUS risk factors (2 + specifics)
Fam Hx stroke
Hereditary connective tissue disorder (Marfan syndrome, Ehlers-Danlos syndrome, ADPKD, Fibromuscular dysplasia, Osteogenesis imperfecta)
T/F
DISSECTION-TRAUMATIC is more common than SPONTANEOUS
True - of the head/neck
TRAUMATIC DISSECTION-how does it occur?
hyper extension/rotation of the neck stretches ICA over cervical vertebrae = intimal tear
Blood enters space between layers of the vessel = false lumen = stenosis/occlusion
What can cause emboli?
Dissection
Cardiac thrombi
Atrial fibrillation
DISSECTION TX
Prevent development/continuation of neurological deficits
Observation, anticoagulation, stent implantation, carotid artery ligation
DOUBLE LUMEN SIGN represents
Arterial dissection
ANEURYSM vs PSEUDOANEURYSM
True aneurysm = all artery wall layers are intact but stretched
Pseudoaneurysm = hematoma that forms from a leaking hole in arterial wall. Contained by the surrounding tissues. Communicates with the artery
A patient presents with a PULPABLE PULSALTILE MASS - what do you suspect?
Pseudoaneurysm
CCA PSEUDOANEURYSMs caused by (3)
Blunt/penetrating trauma
Infection and vasculitis
Iatrogenic
ICA PSEUDOANEURYSMS caused by (4)
Penetrating trauma
H/N surgeries
Carotid endarterectomies
Metastatic LN/neoplasms
DOPPLER PSEUDOANEURYSM
Bidirectional turbulent flow within the neck containing the vessel to the pseudoaneurysm
