Cns Vascular Disease

Front 1

What neurons are most sensitive to acute ischemic injury?

Back 1

1. Pyramidal layer of hippocampus

2. Cerebellar purkinje cells

3. Pyramidal neurons in cerebral cortex

Front 2

What is the MCC of general cerebral ischemia?

Back 2

1. Hypotension from sepsis

2. Cardiac arrest

3. Severe hemorrhage

Front 3

What is the MCC of focal cerebral ischemia?

Back 3

1. In situ thrombosis

2. Embolization

3. Vasculitis

Front 4

What is the MCC of a red infarct?

Back 4

1. Initially non-hemorrhagic

2. Hemorrhage develops due to reperfusion injury

3. Embolic events

Front 5

Where do red infarcts most commonly occur?

Back 5

1. MCA area

2. Involvement of small vessels MC

Front 6

What are the ssx of a red infarct?

Back 6

1. Sudden onset of a deficit that is most severe at the outset

Front 7

What is the MCC of pale infarcts?

Back 7

1. In situ thrombosis--- atherosclerosis and plaque rupture

2. MC: carotid bifurcation, origin of MCA, either end of basilar artery

Front 8

What is the morphology of pale infarcts from 12-48 h?

Back 8

1. Pale, soft, and swollen

2. Endothelial and glial cells well

3. Neutrophils begin to infiltrate

Front 9

What is the morphology of pale infarcts from 48 hours-several weeks?

Back 9

1. Brain becomes gelatinous and friable

2. Edema resolves

3. Pseudolaminar necrosis develops

4. Macrophages move in

Front 10

What is pseudo laminar necrosis?

Back 10

1. Uneven destruction of the neocortex

2. Some destroyed, some liquified

Front 11

What is the morphology of a pale infarct months after the insult?

Back 11

1. Large cavity filled with CSF

2. Gemistocytes border cystic space

Front 12

What is the MC risk factor for deep brain primary parenchymal hemorrhage?

Back 12

1. HTN

Front 13

What is the MCC of lacunar infarcts?

Back 13

1. Hyaline arteriolosclerosis

Front 14

Where are the MC sites for lacunar infarcts?

Back 14

1. Basal ganglia

2. Thalamus

3. Deep white matter

4. Brainstem

Front 15

What are slit hemorrhages?

Back 15

1. Rupture of small-caliber penetrating vessels

2. Hemorrhages resorb, leaving slit-like space

Front 16

What is the microscopic evidence of a slit hemorrhage?

Back 16

1. Pigment-laden macrophages

2. Gliosis

Front 17

What is acute hypertensive encephalopathy?

Back 17

1. Arises w/ malignant HTN

2. Ssx: HA, confusion, vomiting, convulsions

3. Emergency

Front 18

What are the MC sites for massive intracerebral hemorrhage?

Back 18

1. Basal ganglia

2. Thalamus

3. Pons

4. Cerebellar hemisphere

Front 19

What are the MCC of massive intracerebral hemorrhage?

Back 19

1. Trauma

2. Lacunar infarcts

Front 20

what is the MCC of Charcot-Bouchard microaneurysms?

Back 20

1. Chronic HTN

2. Develop at the site of rupture

Front 21

What is amyloid angiopathy?

Back 21

1. Deposition of amyloid in walls of elderly, patients with down syndrome, and Alzheimer's

Front 22

What is the inheritance of amyloid angiopathy?

Back 22

1. AD

Front 23

Where does amyloid angiopathy typically affect?

Back 23

1. Leptomeningeal

2. Superficial cortical cerebral vessels

Front 24

What type of amyloid is deposited in amyloid angiopathy?

Back 24

1. B amyloid peptide in sporadic

2. OR transthyretin

Front 25

What is the MC site of berry anneurysms?

Back 25

1. Anterior circulation

Front 26

What are the genetic predisposing factors for berry aneurysms?

Back 26

1. AD PCKD

2. Type IV Ehlers-Danlos syndrome

3. NF1

4. Marfan

Front 27

What causes a berry aneurysm to burst?

Back 27

1. Can be random

2. Can be inc ease in intracranial pressure

Front 28

What layers of the vessel are absent from the aneurysm in a berry aneurysm?

Back 28

1. Smooth muscle

2. Intima

Front 29

What are the clinical sequelae to a berry aneurysm?

Back 29

1. Subarachnoid hemorrhage

2. Intracerebral hemorrhage

3. Rupture into ventricular system

Front 30

With what type of stroke is a mycotic aneurysm associated?

Back 30

1. Infarct

Front 31

What are the MC sites for Charcot-Bouchard microaneurysms?

Back 31

1. Basal ganglia

2. Bulbar region

3. Cerebellum

Front 32

With what disorder are dissecting aneurysms associated?

Back 32

1. a1 antitrypsin deficiency

Front 33

Where do most AV malformations occur?

Back 33

1. Cerebral hemispheres--- MCA

Front 34

What are the ssx of an AV malformation?

Back 34

1. HA

2. Seizure

3. Focal sensorimotor defects

Front 35

With what diseases are AV malformations associated?

Back 35

1. Osler-Weber-Rendu

2. Sturge-Weber

Front 36

What are the ssx of cavernous hemangiomas?

Back 36

1. Seizures**

2. HA

3. Focal neurologic deficits

Front 37

What are the MC sites for cavernous hemangioma?

Back 37

1. Cerebellum

2. Pons

3. Subcortical regions

4. Often with foci of old hemorrhage, infarction, and calcification around vessels

Front 38

What are capillary telangiectasias?

Back 38

1. Microscopic foci of dilated vascular channels separated by relatively normal brain parenchyma

2. Mostly in pons

Front 39

What are venous angiomas?

Back 39

1. Varices consisting of aggregates of ectatic venous channels