Week 17 - Path

Front 1

acute neuronal injury
-definition?
-results in?

Back 1

-changes assoc. w/acute CNS hypoxia/ischemia
-"red neurons"

Front 2

red neurons
-when are they seen?

Back 2

-12-24 hrs after hypoxia/ischemia

Front 3

gliosis
-indicator of ?

Back 3

-CNS injury

Front 4

categories of cerebrovascular disease?

Back 4

-thrombosis
-embolism
-hemorrhage

Front 5

ischemia
-types?

Back 5

-global cerebral
-focal cerebral

Front 6

global cerebral ischemia
-definition?

Back 6

-2ndary to dec cerebral perfusion (hypotension, cardiac arrest, shock)

Front 7

focal cerebral ischemia
-definition?

Back 7

-impairment blood flow to localized region of brain (atherosclerosis, arteriosclerosis, vasculitis)

Front 8

penumbra
-definition?

Back 8

-region between necrotic tissue and normal brain
-at risk

Front 9

border zone infarcts (watershed)
-definition?
-causes?

Back 9

-infarcts in regions btwn arterial territories (ost distal reaches)
-after hypotensive episodes

Front 10

global cerebral ischemia
-morphologic changes?

Back 10

-general swelling, w/ widened gyri and narrowed sulci

Front 11

thrombotic occlusions
-most common cause?
-most common sites?
-assoc with?

Back 11

-atherosclerosis
-carotid bifurcation, origin of MCA, basilar artery
-HTN, DM

Front 12

embolism
-definition?
-types?

Back 12

-mass that breaks free from site origin and migrates in vasculature
-fat, tumor, air, blood clot

Front 13

paradoxical emboli
-definition?

Back 13

-form in venous system and cross to arterial system

Front 14

vasculitis
-definition?

Back 14

-inflammation of vessel wall

Front 15

hemorrhagic infarct
-assoc with?

Back 15

-embolism

Front 16

nonhemorrhagic infarct
-assoc with?

Back 16

-thrombosis

Front 17

nonhemorrhagic infarct Morphologic findings
-48 hrs?
-2-10 days?
-10 days - 3 weeks?

Back 17

-tissue pale, soft, swollen
-brain gelatinous and friable
-lesion = cystic cavity w/liquefied tissue

Front 18

nonhemorrhangic infarct microscopic findings
-12 hrs?
-48 hrs?
-1 week?
-months?

Back 18

-red neurons
-neutrophilic infiltration
-phagocytic cells from monocytes and microglial cells
-reactive astrocytosis
-glial fibers, new capillaries, perivascular connective tissue, cavity

Front 19

cerebral venous thrombosis
-risk factors?
-sx?

Back 19

-prothrombotic conditions, oral contrceptives, pregancy
-HA w/wo vomit, papilledema, visual

Front 20

spinal cord infarction
-causes?

Back 20

-hypoperfusion, impair blood flow

Front 21

bruits of carotid artery
-reveal?

Back 21

-atherosclerotic ds of arteries

Front 22

hypertensive changes in brain?

Back 22

-lacunar infarct
-slit hemorrhage
-htn encephalopathy
-htn intracerebral hemorrhage

Front 23

lacunar infarct
-definition?
-most common places?

Back 23

-small cavitary infarcts
-basal ganglia, hemispheric white matter, brainstem (deep penetrating arteries)

Front 24

lacunar infarct
-syndromes?

Back 24

-pure motor hemiparesis
-pure sensory stroke
-ataxic hemiparesis
-dysarthria and clumsy hand

Front 25

slit hemorrhage
-causes?
-microscopic?

Back 25

-htn to rupture small pen. vessels - small hemorrhages
-tissue destruction, gliosis, macrophages

Front 26

hypertensive encephalopathy
-causes?
-signs?

Back 26

-malignant htn
-HA, confusion, vomit, convulsions, coma

Front 27

hypertensive encephalopathy
-morphology?
-microscopic?

Back 27

-edema in brain w/out tonsilar herniation
-petechiae and fibrinooid necrosis of arterioles

Front 28

vascular dementia
-types?

Back 28

-multi-infarct
-diffuse white matter ds (binswangers)

Front 29

multi infarct dementia
-definition?
-sx?

Back 29

-multiple, bilat grey matter and white matter infarcts
-dementia, gait abnormalities, pseudo bulbar signs, neurologic deficits

Front 30

epidural hematoma
-artery injured?
-dura placement?

Back 30

-middle meningeal artery
-dura peeled off skull

Front 31

subdural hematoma
-vasculature?
-dura palcement?

Back 31

-bridging veins
-dura still attatched to skull

Front 32

epidural hematoma
-sx?
-radiologic?

Back 32

-head trauma, HA, vomit, drowsiness, confusion, aphasia, seizure, hemiparesis
-lens shaped mass

Front 33

subdural hematoma
-at risk?

Back 33

-elderly (brain atrophy)
-infants (bridging veins have thin walls)

Front 34

subdural hematoma
-sx?

Back 34

-HA, lightheadedness, cognitive impairment, apathy, insomnolence, hemiparesis

Front 35

intracerebral hemorrhage
-cause?
-factors?
-most common site?

Back 35

-rupture of small intraparenchymal vessel
-htn, cerebral amyloid angiopathy, coag disorder, neoplasm, vasculitis, aneurysm, vascular malformation
-putamen

Front 36

charcot-bouchard microaneurysms
-assoc w?
-definition?

Back 36

-chronic htn
-vessels less 300um and usually in basal ganglia

Front 37

intracerebral hemorrhage
-morphology?
-microscopic?

Back 37

-acute: collection of blood; old: cavity w/brown tint

Front 38

cerebral amyloid angiopathy
-definition?
-leads to?

Back 38

-amyloid deposition in small/med b. vessels of meningeal and corticalvessels
-weak vessel wall

Front 39

CADASIL (cerebral autosomal dom. arteriopathy w/subcortical infarcts and leukoencephalopathy)
-definition?
-microscopic?

Back 39

-hereditary type stroke
-thickening of arteries, basophilic

Front 40

subarachnoid hemorrhage
-cause?

Back 40

-rupture of berry (saccular) aneurysm
-atherosclerotic aneurysm

Front 41

subarachnoid hemorrhage
-inc incidence in?

Back 41

-AD polycystic kidney ds
-ehlers-danlos
-neurofibromatosis type I
-marfan
-HTN, cigarette

Front 42

subarachnoid hemorrhage
-clinical sx?

Back 42

-severe HA

Front 43

vascular malformations
-types?

Back 43

-arteriovenous
-cavernous
-capillary telangiectasias
-venous angiomas

Front 44

arteriovenous malformation
-location?
-definitoin?
-sx?

Back 44

-MCA territory
-mass of enlarged b. vessels and gliotic tissue
-seizure, intracerebreal hem. subarachonoid hem.

Front 45

cavernous malformations
-definition?
-location?

Back 45

-large, irregular vessels w/thin collagenous walls
-cerebellum, pons, subcortical areas

Front 46

capillary telangiectasias
-definition?
-location?
-sx?

Back 46

-aggregates of dilated, thin walled vessels separated by brain parenchyma
-pons
-asymptomatcic

Front 47

venous angiomas
-definition?

Back 47

-ectatic venous channels