Flashcards in Week 7 Deck (47):
What is hydrocephauls?
Accumulation of CSF in ventricular system, will increase hydrostatic pressure
CSF is produced by __ __ in the ventricles
Amount of CSF produced in 24 hrs.
The 4 ventricles of the brain can hold __ ml of CSF
**Sidenote: Draw out a CSF circulation
Communicating Hydrocephalus AKA
COmmunicating Hydrocephalus: Leptomeningitis- swelling of the __ granulation and will cause increased accumulation of ___ in the ventricles. The gyri jam up against the brain and __. This can cause a __.
Non Communicating hydrocephalus: Can be congenital, or acquired __ in some part of the ventricular system or from a mass such as a __ __ (or hemorrhagic stroke) which blocks the normal flow of fluid.
What are the 3 classic signs of Hydrocephalus?
2. Nausea/ Vomiting
3. Papilledema (swelling of optic disc)
What causes papilledema with hydrocephalus?
Increased ICP and prevention of normal venous outflow from the retina and disappearance of the clear boundary in the optic disc. Disc becomes opaque.
Alzheimer's: Amount of CSF if __ than it is supposed to be. Accumulation of fluid due to disappearance of __ tissue. Does not __ pressure because there is a loss of tissue and increased space in the skull. What is this known as?
Hydrocephalus ex vacuo
Huntington's can also cause ____ since the brain is atrophied. Also causes __ due to atrophy of striatal neurons. __ ganglia are damaged.
Hydrocephalus Ex vacuo
Under normal circumstances, the brain receives __% of the cardiac output and utilizes about __% of the O2 consumed by the body.
Cerebral Vascular diseases (CVD) aka __ fall into 3 main categories. WHat are they?
Infarcts (Ischemic stroke)
Hemorrhages (hemorrhagic stroke)
Infarcts (ischemic strokes) are caused by __ vascular __- can be partial or complete. These account for __% of all CVDs.
Infarcts: Total Lacunar Infarction (AKA ___): Capillaries undergo __ changes and they get obliterated--> ___. MC with advanced __.
Hemorrhages occur within the brain __ of the __ space. These account for __% of all CVDs). May be __ or __.
Parenchymal injuries are associated with general reduction in __ flow, including global hypoxic-ischemic encephalopathy. Dilation of vessels may lead to __ __.
What are 2 sources of thrombosis?
What are the 2 types of Hemorrhagic stroke?
Intracerebral/ parenchymal/ hypertensive
Subarachnoid Hemorrhagic Stroke AKA Berry/ Saccular Aneurysm
Hemorrhagic stroke: Intracerebral: Long term __ leads to deposition of __ in the vasuclar wall making it brittle and with increased pressure can cause rupture of these vessels and leakage into __ tissue.
* blood can cause atrophy of brain tissue as it acts like a toxin to tissues when not in the vessel
Hemorrhagic Stroke: Subarachnoid (Berry): What is the problem in this condition? Where is MC? Where will hemorrhage occur?
Person is born with a weak middle layer of arteries--> Saccular or Berry aneurysm develops
MC in ACA
Hemorrhage occurs around the brain
Subarachnoid (Berry): Less than __ cm in diameter. Typically ruptured before __ y/o. Between __-__mm is most easily ruptured.
Giant Aneurysm: Can get up to __cm in diameter. Manifestation is similar to __ __
TIA: Fibrinolytic activity of blood can dissolve a thrombi after it obstructs the lumen and only obstructs blood flow for a short time. How is this manifested?
Decreased blood flow to retina
What is Amaurosis Fugax?
Painless, temporary unilateral vision loss in one eye causes by temporary thrombosis of ophthalmic A.
3 types of CNS trauma; traumatic brain injuries
Brain traumatic parenchymal injury
Epidural Hematoma: Caused by rupture of the __ __ artery usually bc of its relationship with the weak __ bone. Pressure is so high that __ will separate from __ vault. Brain will swell due to prevent of __ outflow
What are manifestations of subdural hematoma?
-Pain and neuro deficits (possible loss of consciousness)
-Swelling--> additional compression
What are the 3 types of herniations that may develop with epidural hematoma?
Subfalcine (least dangerous)
Transtentorial (uncal/uncinate) (More dangerous)
Cerebellar (Tonsilar) (Most dangerous)
Subfalcine herniation: Compression of __ __ against __ __. This can also cause compresson of which artery?
anterior cerebral Artery
Transtentorial Hernia: Compression of __ margin of __ lobe against the __ __. Can cause compression of __ __ artery. Can cause compression of the __ fibers of CN__ --> may lead to permanent __ of pupil on the side of damage.
Cerebellar Herniation: Located in __ __ __. Acute version of __ __ malformation. Results in __ __ compression impacting __ and __ centers. __ hematoma can cause this and will lead to death.
posterior cranial fossa
Duret Hemorrhage AKA __ __ __ is associated with __ hemorrhage. Due to kink in __ artery
secodary brainstem herniation
Subdural Hematoma: Blood doesn't collect in a preexisting space, but rather creates one at the __-__ junction. Usually follows __ that jerks the brain inside the head and damages it. Usually __ in origin coming from __ vein as it enters __ __ sinus.
Subdural Hematoma: Lower blood pressure in __ veins makes damage not that bad. what are some possible manifestations?
headache, loss of consciousness, blindness, spots in eyes
Concussion: damage to what part of the brain? This can cause what 2 manifestations?
Reticular Activating system (RAS)
-Loss of consciousness- seconds to hours
-Retrograde amnesia- permanent loss of memory on events immediately prior to, during, and after the trauma.
Diffuse Axonal Injury: Stretching of ___ of __ matter. Usually associated with __. Most commonly involves which part of brain? What will you find with this?
-Axonal Spheroids- aappear 2 hrs. after trauma (also found in alzheimers)
Contusion: Hemorrhage into the __ __ due to blunt trauma. Will have anatomical damage. Whata are the 2 types?
Contusion: Coup: Damage of brain directly __ the area- head is __ and forced __.
"Vinnie, hit him in the ehad with a baseball bat."
Contra coup: Damage is in __ lobe if hit in the back of the head. Head __ forced __.
"Vinnia, slam his face into the cement."
Laceration: Tear of brain tissue and rupture of vessels--> __. Can be in two areas. what are they?
Laceration: MC involves which 2 areas of brain?
Basilar skull fracture: Can cause interruption of __ __ or opening for __. What are the 2 common types?
Fx of Orbital plate of Frontal Bone
Fx of pyramid of temporal bone
Basilar Skull fracture: Fracture of orbital plate of frontal Bone: __ __ hemorrhage. Will cause __ eyes. Pt. will always have ___. Can cause __ because there is an opening in the brain.
rhinorrhea- CSF leakage (bc crack in basement of skull)
Basilar Skull fracture: Fracture of pyramid of temporal bone: Hemorrhage behind the ear = __ sign. Can cause ___.
Otorrhea- leakage of CSF from ear