Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
25 Cards in this Set
- Front
- Back
Name the four common etiologies of Cerebrovascular disease
|
ischemia/hypoxia, infarction, hypertensive CVD, intracranial hemorrhage
|
|
Characterize the two types of ischemic CVD
|
Global- caused by a fall in cerebral perfusion pressure below that compensated by autoregulation(45-170mmHg)& Focal ischemia- due to stenosis or arterial occlusion
|
|
Discuss the etiology of Global Ischemia
|
cardiac tamponade (low blood pressure) or raised intracranial pressure (trauma) results in infarction accentuated in watershed areas or areas where two blood supplies anastamose (parasaggital)
|
|
What neuronal populations are most sensitive to hypoxia?
|
CA1 in hippocampus, Layer 3 & 5 ex/internal pyramidal cells in the cerebral cortex, Cerebellar purkinje neurons
|
|
In general what neurons are most susceptible to hypoxia?
|
Large ones
|
|
What are the major causes of brain hypoxia?
|
Low O2 Content (Carbon monoxide poisoning), ischemia, histotoxic hypoxia-an inability of the tissue to utilize the oxygen (cyanide poisoning)
|
|
What are the morphological changes associated with hypoxic neurons?
|
Neurons turn pink or red and pyknotic (neurons shrink and become obscure)
|
|
Define stroke.
|
A clincial term used to describe a cerebrovascular accident/focal neurological deficit due to a vascular disorder syndrome lasting greater then 24 hours. (70%)infarction or (30%)hemorrhage.
|
|
Define cerebral infarction.
|
Vascular necrosis characterized by death of all cellular components.
|
|
What are some common causes of cerebral infarction?
|
Embolic events-atherosclerotic
Thrombotic events- basilar artery Venous occlusion- related to infectious processes |
|
How does one categorically date infarctions?
|
Acute- identical to global ischemia PMN infiltrate
Subacute- Macrophage infiltration, increase in vasculature. Remote/cystic- cavitary lesion with some gliotic cells |
|
What is the major manifestation of hyertensive cerebrovascular disease?
|
Intracerebral hemorrhage, lacunar infarct, subcortical atherosclerotic leukoencephalopathy and hypertensive encephalopathy
|
|
What are the major areas of the brain affected by hypertensive cerebral artery disease.
|
Hemorrhage in basal ganglia straight striate arteries (have a right angle thus very susceptible to changes in bp)
Brainstem (another common area) is fatal |
|
Descirbe and discuss the etiology of the lacunar infarct.
|
small cavitary infarct seen in the basal ganglia and the thalamus associated with HTN...typically Asympotomatic unless it occurs in the anterior limb of the internal capsule
|
|
Discuss/Describe the etiology of subcortical atherosclerotic leukoencphalopathy.
|
Slow gradully progressive disease associated with the elderley, AD, hypertension and dementia
|
|
What is hypertensive encephalopathy?
|
Occurs in the setting of a sudden rise in bp (>200)eliciting a severe headache, vomitting and visual auras...predisposed by pregnancy or glomerular nephritis
|
|
What are the three different manifestations of intracranial hemmorrhage?
|
Subarachnoid
Intraparenchymal Epidural- traumatic rupture of the middle meningeal artery in the epidural space Subdural- seen in elderley associated with senescent atrophy of brain and stretching of vasculature...associated with very minor trauma in elderly |
|
What are the major risk factors associated with intracranial hemmorrhage?
|
Hypertension, ruptured annuerysm and vascular malformation.
|
|
Discuss the common etiology of Subarachnoid Hematoma?
|
1. Non-traumatic rupture of a saccular or berry annuerysm
2. Vascular malformation (5%) 3.infectious/mycotic annuerysm |
|
Where are the majority of annuerysms localized?
|
90% Anterior circulation, 10% posterior
|
|
What are the most common causes of vascular malformation?
|
Arteriovenous malformation (embedded in CNS tissue)second most common cause of SAH, cavernous hemangioma (not embedded), cavitary telengectasia and venous angiomas- clinically silent.
|
|
In what patient population do Arteriovenous malformations typically present?
|
middle aged SAH/focal ischemia, blood shunted from arterial to venous system bypassing arterial bed and resulting in focal ischemia.
|
|
Discuss Cerebral Amyloid Angiography.
|
Manifests as lobar hemorrhage. Always associated with dementing disease such as Alzheimers. Deposition of AB peptide distinguishing it from systemic amyloidosis. Congo (+)
|
|
What are some etiologies of intraparenchymal hemorrhage?
|
Drug abuse, tumors, AVM, hypertensive hemorrhage.
|
|
What are the leading causes of death in the U.S
|
Heart DZ
Cancer Cerebrovascular DZ |