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Vascular - Neuro
Dr. Ziegler Neurological Disease - Vascular
| Term | Definition |
|---|---|
| epidural hematoma | bleeding from meningeal arteries, accumulates between skull and dura |
| subdural hematoma | bleeding usually of cerebral veins, accumulates between dura and arachnoid (bridging vein) |
| subarachnoid hemorrhage | bleeding between arachnoid layer and pia/brain, into CSF |
| meningeal artery | epidural intracranial hemorrhage is a rupture of which artery normally due to head trauma? |
| lens shape | epidural intracranial hemorrhage takes on what type of shape due to the hematoma anterior-posterior expansion until skull sutures are met? |
| bridging veins | subdural intracranial hemorrhage is typically due to which type of vessels that is more vulnerable in the elderly, brain atrophy, or alcohol abuse? |
| longer distance from brain surface to dural sinus | bridging veins in the elderly, brain atrophy, and alcohol abuse are more delicate due to what? |
| cerebral veins | rupture of "bridging veins" are what type of veins that extend into dural sinus (subdural intracranial hemorrhage)? |
| crescent shape | what type of shape does a subdural intracranial hemorrhage take on due the lack of constraints by skull sutures? |
| stroke | (1) hemorrhage within the brain or spinal cord (hemorrhagic) (2) loss of arterial blood supply to brain region due to an artery occlusion (ischemic) |
| ischemic stroke | artery occlusion due to any cause, usually by a blood clot (thrombotic occlusion) or some other material (embolism); results in a region of permanent tissue damage (infarct) |
| infarct | permanent tissue damage resulting from ischemia and hypoxia, where blood flow may be normal but the level of oxygen in the air and blood is low |
| transient ischemic attack "TIA" | an ischemic event where the artery occlusion is brief and resolves spontaneously and rapidly enough that the affected region does not become damaged (transient loss of function followed by complete recovery) |
| cerebrovascular disease | general term encompassing stroke and a range of other pathologies involving blood vessels of CNS (ex: stenosis or arteritis) that can lead to blood clots |
| penumbra | area of salvageable damage around the permanent damage >> less ischemic, transient dysfunction, potentially recoverable |
| ischemic stroke & infarcts sequelae | - damage contained within a single vascular territory - focal distribution - acute onset and usually stable - painless (normally) with no intracranial pressure increase |
| ischemic stroke & infarcts prognosis | severity normally stabilizes and is followed by significant improvement functional recovery is driven by: penumbra, plasticity of brain, rehab |
| causes of ischemic (occlusive) stroke | atherosclerosis, stenosis, artery dissection, atrial fibrillation |
| atherosclerosis | plaque breaks off, forms embolism >> ischemic stroke |
| stenosis | narrowing of lumen of artery reduces cerebral blood flow to suboptimal levels (carotid) >> ischemic stroke |
| artery dissection | incision in lumen wall, creates flap that can occlude >> ischemic stroke |
| arteritis | inflammatory damage within artery wall, triggers clot formation >> ischemic stroke |
| atrial fibrillation (arrhythmia) | clot formation risk due to brief stationary pool of blood in atria and tissue damage in atria can activate clotting cascade; newly formed clot travels via common carotid, up internal carotid, most likely up MCA (or oph artery or ant cerebral artery) |
| carotid stenosis | buildup of atherosclerotic plaque in lumen of common carotid near bifurcation into external and internal (or just distal to birfucation); reduces blood flow |
| thrombosis or embolism | carotid stenosis causes what two things within the MCA (or oph artery or ant cerebral artery)? |
| bruit | turbulent "whooshing" sound is often accompanied with carotid stenosis |
| carotid endarterectomy | surgical removal of atherosclerotic build-up (high risk : benefit) |
| carotid occlusion | some patients may gradually develop complete filling occlusion of a long segment of the ICA but are functionally intact due to a gradual compensation through collateral blood flow via circle of willis |
| carotid/vertebral dissection | trauma-induced tear in the internal lining of the vessel, creating a flap of tissue protruding in the lumen that can occlude the vessel ('pop') - can trigger thrombosis |
| presentation of carotid/vertebral dissection | pain in distribution area (orbital pain w/ carotid; neck/occipital pain w/ vertebral), signs of transient ischemic attacks, ipsilateral Horner's syndrome |
| vasculitis | inflammatory disease in larger arteries involving the elastic lamina, damage progresses to affect the rest of the vessel (can lead to ischemia) |
| giant cells | macrophages that have fused together |
| temporal arteritis "giant cell" | risk of 2º ischemia due to occlusion or significant narrowing; can develop in CNS (esp. neuro-oph pathway "ION"); pt may have already experienced transient visual loss >> EMERGENCY to prevent blindness! |
| GCA presentation | - visible loss of blood perfusion in affected side of face - enlargement of vessels within scalp - aches, pains, tenderness in arterial distribution - jaw claudication (tender while chewing) |
| aneurysms | dilation of artery wall with a lumen (blood); can occur at multiple points but often occurs at branch points (bifurcation of basilar into PCA); can bleed or compress nearby structures |
| arteriovenous malformations "AVM" | failure to form capillary bed leads to arteries becoming entangled with veins; no blood-brain exchange occurs (ischemia); can rupture (intra-parenchymal hemorrhage) |
| anterior ischemic optic neuropathy "AION" | ischemia of anterior optic nerve (portion in the orbit) is a common cause of sudden vision loss; painless and reduced C/D |
| circle of willis | intracranial ON, chasm, tracts are much less vulnerable to ischemia due to what? |
| arteritic AION | in temporal arteritis, inflammatory process occludes arteries |
| nocturnal hypotension | AION can result from this with the patient noticing vision loss on waking |
Created by:
kycokate
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