name the 3 signs and symptoms of increased intracranial pressure
- headache
- nausea and vomiting
- papilledema ( swelling of optic disc)
state the characteristics of hydrocephalus ex vaco
- more common in elderly
- result in brain atrophy brain kdisease
- associaTED WITH LOSS OF NEURONS OR AXONS IN THE WHITE MATTER
- LEAVES INCREASED SPACE IN CRANIAL FOSSA FILLED WITH CSF
- disease associated with alzzheimer’s
list the symptoms of hydrocephalus ex taco
- bent knees
- stooped posture
- incontinence
- loss of memory
T/F Hyrdocephalus is a common condition in children
true
describe how children may suffer from hydrocephalus
- could be a dramatic increase of anterior fontanel and results in cranial hemangioma
- during childbirth the bones may get stuck and pushes parietal bones
- obstructs sagital sinus
name the two complications with hydrocephalus
- increased intracranial pressure
2. herniation of cerebellar tonsils
T/F
under normal circumstances, the brain receives 20% of the cardiac output and utilizes roughly 15% of the oxygen consumed by the body
false it is the opposite percentages
what is the # 3 cause of death in US
Cerebral vascular disease (stroke)
name the 3 types of strokes
- generalized reduction in blood flow
- infarct
- hemorrhage
which stroke is due to an anaphylactic shock and causes the dilation of blood vessels and the blood all goes to the abdominal cavity due to gravity from the brain
- occurs 5% cases of strokes
- generalized reduction in blood flow
describe the characteristics of ischemic stroke
- aka is infarct
- it is caused by local vascular obstruction
- it is 80% of cases - most common source
- due to obstruction of blood flow in cerebral vessels of brain
- necrotic tissue forms due to hypoxia
name the characteristics of a hemorrhage stroke
- it is within brain parenchyma or the subarachnoid space 15% CVD
- may be intracerebral or subarachnoid
- a lacunar infarction is involved (aka hyaline arteriosclerosis)
- deals with byline change
- this is more common with advanced hypertension
Describe the mechanism of stroke development
- a formation of atheroma in arterial wall which will lead to activation of platelets and give rise to a thrombus which will grow until it obstructs the lumen and tat portion of brain undergoes necrosis - (liquifactive necrosis)
- it is replaced by microglia
T/F
neuroglia assists in healing of the tissue of the brain and usually results in the shrinking of the brain … this repaidr is called gliosis
False
neuroglia does not shrink like connective tissue does
describe what a lacunar infarction is
it deals with hyaline cartilage and is arteriosclerosis of the capillaries and undergoes obliteration resulting in micro infarctions
- more common with advanced hypertension
in haline arteriosclerosis there are infarcts in nuclei of ____
midbrain
what is the common cause of an ischemi stroke
thrombosis
- the emboli breaks off and travels through circulation and obstructs vessels with smaller lumen = causes infarction
name the favorite places of atheroma development
- cerebral artery
- mesenteric artery
- coronary artery
- artery of extremities
name the common location of atheroma
- bifurcation of common carotid artery
- bifurcation of internal carotid artery
( splits into middle and anterior cerebral arteries)
where is the most vulnerable for ischemic stroke
territory of middle cerebral artery
_______ is important source of thrombosis and goes to areas with good blood supply
mitral stenosis
______ ______ creates embolism and development of hemmorrhagic stroke
bacterial endocarditis
list some causes of an ischemic stroke
- mitral stenosis
- bacterial endocarditis
- artificail valve
- MI
Transient Ischemic Attack AKA
- temporary ischemic stroke
pt cannot talk, walk and has unilateral loss of vision .. the episode lasted for a short time and everything restored to normal …. what type of stroke is this
- Transient ischemic attack
- 1/3 of patients = TIA develops into real stroke after 6 months
Name the two AKAs of intracerebral hemorrhagic stroke
- parenchymal hemorrhagic stroke
- hypertensive hemmorrhagic stroke
which stroke usually develops in people with long term advanced hypertension
- Intracerebral hemorrhagic stroke
describe how hypertension results in hyaline arteriosclerosis
there is replacement of vascular wall with hyaline protein (glass-like) , the wall becomes more brittle and is prone to rupture due to increase bp which leads to rupture of arteriole
name the two AKA of subarachnoid hemorragic stroke
- saccular aneurysm
- berry aneurysm
describe what amaurosis fugax is
- is a manifest in temporary unilateral loss of vision
- associated with temporary thrombosis of opthalmic artery
_________ arteries are most commonly involved in hypertension
lenticulostriae arteries
list some results in herniration of the brain
- inflammation of cerebellar tonsils into foramen magnum (most serious)
- arnold- chiari malformation
list what usually occurs in a intracerebral hemorrhage stroke
- hypertension
- mechanical compression of brain tissue ( non- communicating hydrocephalus)
- heniations
- chemical function of blood in nervous tissue becomes toxic
- produce loss of consciousness
what usually is the cause of a subarachnoid hemorrhagic stroke
- result of a rupture of aneurysm
- 1% of pop. have it
- from people born with weak middle layer of arteries
- has a weak muscle layer of the bifurcation - leads to slow pouching of vascular wall develops into aneurysm
what are the percentages of distribution of congenital cerebral aneurysm
- 30% ant cerebral artery
- 30% internal carotid artery
- 25% middle cerebral artery
- 2% post cerebral artery
- 10% basilar artery
- 3% vertebral artery
T/F
aneurysm is no more than 3 cm in diameter
false
1 cm
what measurement is most vulnerable for a rupture
4mm to 7mm
name some characteristics of giant aneurysm
- greater than 1 cm up to golf ball size 5cm
same symptoms of a brain tumor due to increase pressure atrophy- hedaache, nausea and vomitting and papilledema
- not as vulnerable to rupture as berry aneurysm
name the 3 categories of brain injuries
- epidural hematoma (above dura)
- subdural hematoma (below dura)
- traumatic parenchymal brain injury