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30 Cards in this Set
- Front
- Back
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what % of strokes are intracerebral haematoma (haemorrhage)?
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15%
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What % of case fatality is there within the first month?
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20-30%
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What portion of stroke survivors are disabled within the 1st year
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1/3
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Which region of tissue is reversibly injured?
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penumbra
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what are the two most common causes of acute ischaemic stroke?
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atherothrombosis and embolism
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atherosclerosis is an
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inflammatory process
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components of atheroclerotic plaque are
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inflammatory
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subarachnoid haemorrhage is
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the rupture of a blood vessel into subarachnoid space
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after SAH there is a risk or
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re-bleeding or delayed cerebral ischemia (DCI)
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what % is SAH
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5%
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SAH is generally related to what age group?
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~50yrs
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the case fatality % of SAH is
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50%
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inflammation has been proposed to play a role in risk in stroke e.g...
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plaque progression
destabilisation and thrombo-embolism first stroke/recurrent stroke |
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inflammation has been proposed to play a role in stroke repair and
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evolution
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what are the challenges of assessing neuroinflammation in patients?
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access to CNS tissue
Complexity/cost of imaging equipment assessment of ill/confused patients interpretation and validity |
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What methods are available for assessment in patients?
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functional imagine, MRI, PET
brain tissue biopsy evaluate CSF, plasma |
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MRI involves the injection of..
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ultrasmall particles of iron oxide
USPIO |
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USPIO are preferentially phagocytosed by
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monocytes
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when there is a large amount of infarct injury, there will be a recruitment of
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monocytes
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PET is the in vivo quantification of..
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cerebral blood flow, metabolism and receptor binding
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PET involves the injection of a
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radiolabelled tracer - positron emitting
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11 C-PK11195 is a common PET tracer for
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microglia activation
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18 F-2-deoxyglucose is a common PET tracer for
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macrophage activation
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SPECT involves the injection of a
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radiolabelled tracer - gamma emitting
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what are the limits with examination of brain tissue?
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limited to post mortem or brain biopsy
ethical/logistical issues |
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CSF should reflect what is going on in brain more so than bloody why?
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initimately associated with brain
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CSF tends to be taken from which patients?
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severe state - selection bias
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What are the limitations with taking CSF?
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often mixed with blood, hard to tell what came from where
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plasma sampling in acute stroke is useful for what?
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measuring inflammatory mediators in systemic circulation eg. IL-6 and CRP
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plasma sampling in acute stroke has little value for measuring what
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mediators released at site of inflammation eg. TNF-a, IL-1
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