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21 Cards in this Set
- Front
- Back
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What are two common causes of intracerebral hematoma (ICH)?
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Hypertension
Amyloid Angiopathy |
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What's Amyloid Angiopathy?
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It's a common cause of ICH. Amyloid protein deposits and accumulates on blood vessel walls, leading to their breakdown and thus ICH. You can see the hemorrhages anywhere in the brain.
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What's characteristic of arteriovenous malformations (AVM)?
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Nidus - tangle of small vessels that directly connect arteries with veins without a normal capillary bed.
This can lead to blood steal where the brain is less perfused, and also can increase risk of hemorrhage due to high pressure in the receiving veins. |
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If after a surgery to fix a hemorrhage, the size of the hemorrhage does not decrease, what might this indicate?
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POSSIBLE NEOPLASM! Enhancing MRi will show a thick rim of contrast to indicate a tumor.
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What causes most subarachnoid hemorrhages?
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Aneurysms, especially in basal cisterns.
traumatic brain injury |
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What do patients with subarachnoid hemorrhages complain of?
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"brick to the head" sudden terrible headaches
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What are some complications of subarachnoid hemorrhages in basal cisterns?
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Hydrocephalus - blood can clog the reuptake of CSF
Vasospasm - blood vessels can spasm down and get small if there's blood in the area, leading to secondary cerebral ischemia |
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Where do most saccular aneurysms occur?
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They tend to occur at arterial bifurcations in the circle of willis.
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What are common causes of ischemic stroke?
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Cardiogenic embolism
large-artery atherosclerosis (eg. internal carotid artery) Small-artery (<1mm) occlusion --> lacunar strokes |
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What do we look at for ischemic stroke in imaging? Hint: 2 P's.
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Parenchyma - presence and size of infarction
Pipes - vessels - occlusions in vessels |
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What signs show on the CT if there is infarcted matter?
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Hypodensity - darker area. Can be due to cytotoxic edema
Note: if the hypodensity is large (more than 1/3 the area of MCA distribution), then poor outcome and more likely to hemorrhage after reperfusion. |
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On a DWI, how does an acute infarct show? Brighter or darker?
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Brighter - less diffusion.
Darker is a chronic ischemic stroke. |
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How do you treat ischemic stroke?
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IV-tPA if arrive in ER within 3 hours - NCCT is sufficient for eligibility of this treatment.
Intra-arterial (IA) thrombolysis - going in to the artery with a catheter and injecting tPA directly in there. - depends on "core" and "penumbra" mismatch. |
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How does a cardioembolism show on imaging?
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It generally shows as multiple, bilateral infarctions.
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During the ictus of a seizure, does SPECT show increased or decreased blood flow?
What about inter-ictal or late post-ictal? |
Increased blood flow during the ictal phase.
decreased blood flow in late or inter. |
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During the inter-ictal or late post-ictal phases of a seizure, does PET show increased or decreased glucose metabolism?
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Decreased glucose metabolism.
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What are common anatomic lesions of epilepsy?
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Mesial temporal sclerosis
Congenital disorders of cortex formation neoplasm less common: cortical gliosis, neurocysticercosis |
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What brain area is involved in mesial temporal sclerosis?
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Temporal lobe, more specifically atrophy and gliosis in the HIPPOCAMPUS.
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Is this scarring (gliosis) or edema? How can you tell?
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This is gliosis! Mass effect shows PULLING toward lesion.
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What can we use to demonstrate areas of eloquent cortex?
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fMRI and diffusion tractography (preferential flow of water in white matter axons).
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What is neurocysticercosis?
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Infection caused by pork tapeworm. Leads to multiple cysts with larvae in the brain.
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