Reading...
Play button
Play button
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;
11 Cards in this Set
- Front
- Back
|
types of stroke and prevalence
|
80% ischemic
20% hemorrhagic -intracerebral, from HTN -subarachnoid (berry...) |
|
|
discuss the gross changes that occur after a cerebral infact, during weeks 1-4
|
week 1 - coagulative necrosis, swelling, blurred margins
week 2-3 - liquefactive necrosis, sharply demarcated margins week 4+ - cavitation, gliosis |
|
|
discuss the microscopic changes that occur after a stroke, during weeks 1-4
|
week 1 - eosinophilic degeneration of neurons (as the nucleic acid breaks up), endothelial swelling, brief PMN influx
week 2-3 - macrophages (chew up cells -> liq necrosis) and astrocytes (astros lead to the demarcated borders that form now) week 4+ - cavity forms, "astrocyte scarring" |
|
|
where are the infarcts after a stroke?
|
usually in the area supplied by Middle Cerebral Artery. often due to reperfusion
|
|
|
what two CNS locations are particularly susceptible to ischemia
|
hippocampus CA1 cells, cerebellar purkinje cells
-or a watershed area |
|
|
infarcts can occur from thrombosis or other emboli. where may a thrombus form?
|
carotid bifurcation
|
|
|
strokes can occur due to emboli. where may they arise
|
-from heart (thrombotic emboli after MI, septic emboli from IE)
-from carotid thrombus -fat, air, tumor -infections (toxoplasmosis, aspergillosis, CMV) -CADASIL (cerebral autosomal dominant arteriopathy w/ subcortical infarcts and leucoencephalopathy) |
|
|
hemorrhagic strokes - causes
|
if due to HTN, usually will occur where blood is at highest P, such as basal ganglia or pons/cerebellum
-or a berry aneurysm (also potentiated by HTN??) into subarachnoid space -ArterioVenous malformation, cavernous hemangioma, reperfusion also can lead to hemorrhagic stroke |
|
|
discuss the vascular malformations in the brain. which are clinically significant
|
-A/V Malformation - arterial blood is shunted into vv - the P is too high - can leak (seizures) or rupture (hemorrhagic stroke)
-Cavernous angioma - dilated, hyalinized vv, compacted together, can rupture -venous angioma - dilated vv which are dispersed in brain, (not bunched together like cavernous). clinically insignificant |
|
|
what is Binswanger Disease
|
called "white matter infarct", it is seen in a HTN pt if they suddenly become hypotensive. their hyperplastic arterioles will not be functional at a low BP, and myelin is damaged
|
|
|
what does "leucoairosis on MRI" mean
|
not an area of infarct. shows up on MRI and is apparently not a problem
|
