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48 Cards in this Set
- Front
- Back
What are the main categories of arteries to check
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carotid arteries-->ICA bilat
vetebral- basilar circulation anterior cerebral circulation posterior cerebral circulation |
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What do you dictate if normal
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no evidence of stenosis, occlusion, or aneurysm.
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In addition to aneursym, stenosis, occlusion what else do you look for on brain angiography
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AVMs
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How do you check the perfusion study
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first look at the volume and this should correspond to an infarct. Then look at the MTT. These should be the same size. If MTT is bigger it means there is a pneumobra and an area of ischemia
M (increased) - V (decreased)= pneumbra |
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What two parts of the perfusion scan are looking at the same thing
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MTT and CBF (MTT is used at CSMC)
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What is the volume compared with
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MTT
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What is a pneumbra
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if there is increased size of the flow or MTT compared to the volume and this indicates an area of ischemia in addition to the infarction.
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What must you be able to see on windowing
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plaques within vessels
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what is a good widowing
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200- 800
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What is the a common variant that happens to the A-1 segment
Where is the A-1 segment |
A-1 hypoplasia which results in asymmetric appearance of the beginning of the anterior cerebral artery. This is a normal variant
This after the bifurcation of the MCA and ACA and before the ACA gives off the communicating artery to the contralateral ACA |
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What is a fetal origin of the PCA
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this is when the posterior communicating artery supplies the majority or all the blood flow to the posterior part of the brain on that side. In these cases the posterior communicating artery is absent or contributes a minor amount of blood flow. This is a normal variant
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When the CCA divides in the ICA and ECA what are there postitions
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ICA is posterior lateral
ECA is anterior medial |
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What is the postion of the ICA after it branches from the CCA
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posterior lateral
note it will move around relative to the ECA and eventualy the ECA will be lateral bc it is supplying the blood to the face and head |
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What are the portions of the ICA
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cervical, petrous, precavernous, and cavernous, supraclinoid
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What is does the cavernous portion of the ICA look like
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it is the first horizontal -diagnol portion seen
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What are the branches of the supraclinoid
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OPA
opthalmic poterior communicating anterior choroidal artery |
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What branches the supraclinoid ICA can you see on a CT angio
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posterior communicating (usualy)
anterior choriodal (sometimes) |
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What does the ICA branch into
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ACA and MCA
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What does the posteroir communicationg branch off of
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the supraclinoid ICA
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What part of the code brain should you look at first
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after verifying the CT brain look at perfusion to hone in search
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What is commonly commented on in the cervical carotids
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atherosclerosis.
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What is the relation of the jugular vein to the common carotid
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lateral
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When does the transverse foramen start
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C6
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What is the cause of a prevetebral neck bulge at the region of the thyroid cartilage or C4 area
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the esophagus, this will increase the thickness of the prevetebral space at that level and it may only last a few vetebral levels if the esophagus moves lateral and is no longer anterior to the vetebral body. This can be confused for a mass.
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Does the internal jugular branch of the jugular vein
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no the internal jugular and external jugular are two seperate veins.
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What does the EJ branch off of
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the subclavian vein
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What does the IJ branch off of
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the brachiocephalic which marks the transition of the subclavian vein
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When does the cca bifurcate
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below the hyoid at the level of the thyroid cartilage
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When does the internal jugular vein bifurcate (actual does bifurcate it just gives a branch off)
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at the hyoid bone
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What does the internal jugular vein bifurcate into
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the retromandibular vein and the internal jugular vein
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After the jugular vein gives off the retromandibular vein what is the position in relation to the ICA
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lateral and posterior (C2 to the skull base)
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What is bovine origin of left CCA
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Origin of the Left Common Carotid Artery from the right brachiocephalic artery
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Increased MTT and decreased flow
normal volume |
ischemic pattern
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Pneumbra
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M-V= peenumbra (not F-V)
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perfusion
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Perfusion CT mismatch. Imaging of a 76-year-old woman who had been found unresponsive with a right facial droop. (A) Screening head CT is suggestive of left middle cerebral artery ischemic process as manifested by mild sulcal effacement (large solid arrows) and a subtle insular ribbon sign (small, solid arrows). (B) Perfusion CT performed immediately after the screening head CT reveals decreased cerebral blood volume (CBV) in the left frontal lobe region (white arrows), which is suggestive of irreversible ischemic change. The CBV in the left temporal lobe is normal and symmetric with the right temporal lobe. (C) Mean transit time (MTT) perfusion CT shows increased transit time in the left temporal region (straight white arrows) relative to the right temporal region (curved white arrows), which is consistent with a perfusion deficit. This "mismatch" between the MTT (C) and the CBV (B) perfusion scans (ie, the normal CBV with an increased MTT) suggests the presence of possibly salvageable brain tissue in the left temporal region at that time.
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Can the vetebral artery be small thoughout its course and be normal
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yes
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Do vetebral arteries sometimes end in the PICA
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yes
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If there is a small vetebral artery what must be ruled out
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a long dissection
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where does the PICA artery come off
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the vetebral arteries
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Where does the AICA branch off
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the basilar artery
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What is the formula for the nascet criteria
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What should be mentioned on every report that has a perfusion image part
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dose criteria was reviewed.
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What should the bulb look like on CTA
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the bulbous portion should extend down to the bifurcation if doesnt there is stenosis
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Can the bulb be measured by the NASCET criteria
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no
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What is the cavernous portion of the ICA
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when the ICA is traveling anteriorly towards the ethmoid and before it curves up towards the clinoid
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Where is the clinoid portion
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this is after the ICA is traveling anteriorly and then loops up just at where the clinoids are
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Where is the supraclinoid section of the ICA
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this is when it is traveling posterior and has turned back on its self.
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If there is decreased volume in on a perfusion is there always a stroke
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yes, there is never just decreased volume, however, if there is hyperperfusion to an area of the brain it may look like there is a large area of decreased volume which is not a stroke.
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