Lecture 15 The Pathology of Cerebro-vascular Disease Flashcards Preview

Neurology > Lecture 15 The Pathology of Cerebro-vascular Disease > Flashcards

Flashcards in Lecture 15 The Pathology of Cerebro-vascular Disease Deck (19)
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1
Q

Describe the venous drainage of the brain

A
  • Veins do not accompany arteries

* Large venous sinuses within dura

2
Q

Define ischaemia

A

Lack of blood flow

3
Q

Define Hypoxia

A

Lack of oxygen

4
Q

Define a Stroke (WHO)

A

Focal neurological deficit (loss of function affecting a specific region of the central nervous system) due to disruption of blood supply

5
Q

Cause of a stroke

A

Interruption of supply of oxygen and nutrients, causing damage to brain tissue

6
Q

Interruption of supply of oxygen caused by changes in:

A

o Vessel wall
o Blood flow (including blood pressure)
o Blood constituents

7
Q

In practice 3 main causes of localised interrupted blood supply are

A
  1. Atheroma + thrombosis of artery causing ischaemia
  2. Thromboembolism (for example, from left atrium) causing ischaemia
  3. Ruptured aneurysm of a cerebral vessel causing haemorrhage
8
Q

Whats a common place for atheroma and thrombosis in the circle of Willis

A

Internal carotid artery thrombosis – typically get ischaemia in middle cerebral artery territory (but can affect elsewhere)

9
Q

Describe transient symptoms of ischaemia

A

Transient symptoms (<24 hours) – due to reversible ischaemia(transient ischaemic attack) = tissue still viable

10
Q

Describe longstanding symptoms of Ischaemia

A

Longstanding symptoms (>24 hours)– due to irreversible ischaemia causing localised brain death = infarct

11
Q

Define regional cerebral infart

A

Localised area of brain death

12
Q

What would you see grossly in an area of regional cerebral infarct

A

Congested vessels
Tissue degeneration
Yellow coloration
Swelling around the brain tissue

13
Q

Describe the histology of infarct tissue of the brain

A

Loss of neurones - causes clinical functional deficit
Foamy macrophages –repair process leading to gliosis
Gliosis is CNS equivalent of fibrosis

14
Q

How would an aneurysm form in the cerebral arteries

A

the cerebral arteries have thin walls.

Weakening of wall + hypertension causes aneurysm to form

15
Q

2 common sites of ruptured vessels causing haemorrhagic stroke:

A

Basal ganglia – microaneurysms form in hypertensive patients

Circle of Willis – Berry aneurysm forms in hypertensive patient

16
Q

What can cause generalised interrupted blood supply or hypoxia

A

Low O2 in blood (hypoxia with intact circulation of blood)
Inadequate supply of blood (flow of blood not occurring) – blood may be oxygenated or not
Rarely: Inability to use O2 – eg cyanide poisoning

17
Q

Define Watershed infarcts

A

Pure hypotension with oxygenated blood

18
Q

3 main causes of localised interrupted blood supply

A

Atheroma + thrombosis of artery causing ischaemia
Thromboembolism (for example, from left atrium) causing ischaemia
Ruptured aneurysm of a cerebral vessel causing haemorrhage

19
Q

3 examples of brain injury caused by generalised interrupted blood supply

A

a. Hypotension  watershed infarction
b. Cardiac arrest  cortical infarction
c. Complex case  complex pattern

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