-
What type of event is of sudden onset, which may also refer to the early "signaling" symptoms of a chronic disease?
Acute Onset
-
What type of onset is gradual, "sneaky", and has subtle signs?
Insidious/Progressive Onset
-
What type of stroke occurs when an artery is blocked and part of the brain loses its blood supply?
Ischemic Stroke
-
If this type of occlusion/stroke lasts more than 3 to 5 minutes, it may result in permanent damage or death of brain tissue.
Ischemic Stroke
-
Death of brain tissue is called?
Necrosis
-
Ischemic strokes may be cause by
1.
2.
-
What is a "plug" of material - plaque, platelets, bacteria, etc.?
Thrombus
-
What accumulates at the site of occlucions (larger arteries, bends, and bifurcations most likely sites)?
Thrombus
-
What is usually a blood clot that forms where fatty arteriosclerotic deposits have narrowed the lumen of the artery?
Thrombus
-
What is a piece of material (arterial lining, atherosclerotic plaque, fatty deposit, tissue from a tumor, bacteria) which originates at a remote site, dislodges and travels through the circulatory system until it lodges in an artery which is too narrow to pass through?
Embolus
-
An event where an embolus lodges in an artery narrowed by a thrombus is called?
Thromboembolic CVA event
-
The difference between thrombotic and embolic events.
Embolic events
1.
2.
- 1. have a more sudden onset
- 2. have warning signsthat may be absent or almost undetectable
-
The difference between thrombotic and embolic events.
Thrombotic events
1.
2.
- 1. have a more gradual onset
- 2. often a "step wise" progression of symptoms
-
This attack indicates brief periods of diminished blood supply due to temporary blockage of an artery, is a small plug which lodges temporarily, and a smooth muscle constricution of artery which temporarily closes off the narrowed lumen?
Transient Ischemic Attacks (TIA)
-
A TIA that lasts longer than 24 hours and less than 72, where the symptoms completely resolve?
RIND-Reversible Ischemic Neurological Deficit
-
A TIA that lasts longer than 24 hours and up to a week, where symptoms only partially resolve?
PRIND-Partially Reversible Ischemic Neurol Deficit
-
What is tissue whose functioning is affected by loss of oxygen-supply ("hungry")?
Ischemia
-
What is tissue that has died and is no longer viable (dead)?
Necrose
-
What is an area of damaged, necrotic tissue?
Infarct/Lesion
-
What is swelling of the brain tissue, occurs shortly after event-by the 2nd or 3rd day, and results in widespread displacement/compression of brain tissue and increased intracranial pressure?
Edema
-
What is diminished function of areas that are remote from the site of injury, but connected by the nerve fibers?
Diaschisis
-
Example: An injury to the left temporal lobe (auditory association area) may result in temporary period of slurred speech due to connection through the arcuate fasciculus?
Diaschisis
-
What is similar to "engine flooding"/"spilled fluids on a computer keyboard"? Too much blood, blood overflow.
Release of Excess Neurotransmitters
-
Reflecting the actual localized/focal area of damage?
Residual deficits
-
What is considered to be not a "true" stroke?
Hypoperfusion
-
What is decresed blood flow to peripheral areas due to:
1. lowered blood pressure
2. lowered blood volume
Hypoperfusion
-
Damage is diffuse (verses "dense" or concentrated", damage most likely in "watershed areas" where vessel diameters are smallest (most resistant to flow), and usually has a more gradual onset?
Hypoperfusion
-
Insufficient blood supply to the brain sometimes is caused by _____, in which the brain's blood supply is compromised not by occlusion of arteries but by insufficient blood volume.
Hypoperfusion
-
_____ _____ are caused by rupture or leakage of cerebral blood vessels.
Cerebral hemorrhages
-
Cerebral hemorrhages may be the result of
1.
2.
3.
- 1. weakness of a vessel wall
- 2. traumatic injury
- 3. (rarely) extreme fluctuations in blood pressure
-
What is a pouch-like, ballooning of vessel wall?
Aneurysm
-
What is the pooling of blood from a ruptured blood vessel?
Hematoma
-
Bleeding that is inside the brain as the result of a TBI or resulting from microaneurysms in "penetrating arteries"?
Intracerebral Hemmorhaging
-
Blood on the surface of the brain that is most commonly from rupture of blood vessels or pia?
Extracerebral Hemmorhaging
-
This type of bleeding most often involves th einternal carotid, anterior cerebral, middle cerebral, and basilar artery?
Extracerebral Hemmorhaging
-
Which hematoma is like a sponge of blood?
Intracerebral
-
Which type of hematoma is like a pocket of blood?
Extracerebral
-
Which type of hemmorhaging is more common and more deadly? Subdural or Extradural?
Subdural is 2x as common and 2x as deadly
-
This is a slow leaking of blood that is frequently associated with elderly or alcoholic individuals, that ahve requent falling and brain atrophy?
Chronic Subdural Hematoma
-
Subdural and Extradural
1.
2.
3.
- 1.less common as spontaneous hemorrhages
- 2. more commonly from TBI
- 3. usually related to trauma causing lacerated dural blood vessels
-
Which type of hemorrhage has a loss of blood due to rupture and a toxic effect of blood in contact with the brain tissue?
Intracerebral (blood vessels have ruptured and blood is not getting where it needs to go)
-
Which type of hemorrhage has a loss of blood due to rupture and compresses brain tissue from hematoma?
Extracerebral
-
What treatment is used for a hemorrhage?
1.
2.
- 1. decrease the blood pressure
- 2. increase blood clotting (by using coagulants)
-
What treatment is used for a occlusive/ischemic stroke?
1.
1. decrease blood clotting (anti-coagulants)
-
For which type of acute stroke is the greatest recovery in the first 3-4 weeks?
Occlusive/Ischemic
-
For which type of acute stroke is gradual deceleration of recovery curve until stable?
Occlusive/Ischemic
-
For which type of acute stroke is recovery the greatest for middle-severity range?
Occlusive/Ischemic
-
For which type of acute stroke is there little recovery in the first 4-8 weeks?
Hemorrhagic
-
For which type of acute stroke is it followed by rapid recovery?
Hemorrhagic
-
For which type of acute stroke is there rapid recovery but then it slows and stabilizes?
Hemorrhagic
-
For which type of acute stroke is there usually a higher level of recovery than "equivalent" ______ strokes?
-
A type of insidious processes that are neoplasms which develop within the cranium, are most frequent in individuals 25-50 years old, and often relate to past injury or family history?
Intracranial tumors
-
Intracranial tumors effect the CNS and may be localized or generalized depending on the degree of and "interaction" among various factors:
1.
2.
3.
- 1. size of tumor (larger-more generalized)
- 2. size of growth (faster-more generalized)
- 3. Location (deeper- more generalized)
-
What are some of the early effects of intracranial tumors that are non-specific changes?
forgetfulness, drowsiness, loss of initiative/energy, blurred vision, lightheadedness, vertigo, personality changes, headaches, vomiting, stupor, and lethargy
-
The effects of intracranial tumors are due to:
1.
2
3
- 1. increased permeability of surrounding blood vessels (blood plasma may seep into brain tissue)
- 2. vascular disturbances in area of tumor (blood vessels may be compressed)
- 3. displacement of tissues (severe swelling may result in herniation of brain tissue)
-
What type of herniation occurs within the superior longitudinal fissure (cingulate gyrus pused across falx cerebri)?
Subfalcine
-
Which herniation is most common, least ominous, and may be assymptomatic, unless anterior cerebral artery is compressed resulting in contralateral numbness in leg?
Subfalcine
-
Which herniation involves the mesial temporal lobe pushed "horizontally" into space between cerebrum and cerebellum?
Lateral Transtentorial
-
Which herniation stretches, disorts tissue/blood vessels near the base of the brain and the brainstem Ischemia may compromise life functions?
Lateral Transtentorial
-
Which herniation swells at the apex of the brain pushing the brain/brainstem through the foramen magnum? (may compromise brainstem and life functions?
Central Transtentorial
-
Which herniation consists of the swelling of the cerebellum, pons, medulla, and pushes the cerebrallar tonsils through the foramen magnum? (may compromise life functions)?
Tonsillar Herniation
-
What is the most common form of neoplasm, has 10 types overall, and originates from supporting tissue - glial cells?
Gliomas (Primary Tumor)
-
Which type of Gliomas is the most common, the most benign, the common sites are the cerebellum for children and the frontal and temporal lobes for adults?
Astrocytoma
-
Which type of Gliomas may be dangerous if it is in a location that poses a problem?
Astrocytoma
-
Which Gliomas has symptoms that may appear over 5-6 years and post operative survival is good 10 years +?
Astrocytoma
-
Which Gliomas is the next most common and is seen in ages 40-55, is one of the most malignant and rapidly growing tumors?
Bliobastoma (bad)
-
Which Gliomas has symptoms that may appear within 3 months to 1 year and te post-operative survival is 6 to 9 months (basically said to be a death sentence)?
Glioblastoma
-
This is a tumor that arises from the meninges - often on the dura?
Meningioma
-
This tumor is from trauma at the site, does not invade the brain tissue (stays outside the brain), its relatively common, rare in children - seen in adults 30-50, and one of the most benign?
Meningioma
-
_______ ______ are tumors that form from cancerous cells that have migrated (usually through the bloodstream) from the primary tumor site to the brain, where they settle and grow.
Secondary Tumors
-
This type of tumor mestasizes from a primary cancerous tumor, cells migrate through the bloostream, the home sites for primary tumors are breast, lung, pharynx, and larynx, may result in multiple sites within the brain/considerable swelling around sites, and prognosis is poor - survival is 2 to 6 months.
Secondary tumors
-
A condition in which the cerebral ventricles are enlarged, either as a result of increased pressure in the ventricles or as a result of brain atrophy (shrinkage)?
Hydrocephalus
-
______ _____ is caused by obstruction of the interventricular passageways through which CSF circulates.
Obstructive hydrocephalus
-
The most common site of obstruction is the _____ ______ which is caused by a "plug" or brain swelling that collapses the passageways for CSF.
Aqueduct of Sylvius (Obstructive Hydrocephalus)
-
A build up of CSF occurs due to continued production by choroid plexi.
Obstructive Hydrocephalus
-
A generic label for several conditions that cause ventricular enlargement but do not involve obtruction of interventricular passageway.
Non-obstructive Hydrocephalus
-
An enlargement or the ventricles that does not involve increased intracranial pressure?
Non-obstructive Hydrocephalus
-
Common example of this condition would be "cerebral atrophy" - surrounding brain tissue looses viability, become "mushy", and no longer.
Non-obstructive Hydrocephalus
-
This is a primary medical treatment for ostructive hydrocephalus.
Intraventricular Shunt
-
This is a secondary bacterial infection, bacterial will be transmitted from extracerebral infection sites.
Brain abscess
-
The introduction of bacteria, fungus, or parasites into brain tissues from a primary infection site elsewhere in the body.
Brain abscess
-
The pia, arachnoid, and CSF become infected with bavteria, causing inflammation, swelling, and fluid exudate from the meninges.
Bacterial meningitis/encephalitis
-
Treatment for ____ ____ is antibiotics and draining of abscess.
Bacterial abscess
-
Symptoms from this infection includes faver, chills, headache, stiff neck, drowsiness/lethargy, and papilledema.
Bacterial Meningitis
-
What does the acronym FAST stand for?
Face, Arms, Speech, and Time
-
Pressuring the brain through this large opening can threaten life?
Foramen Magnum
-
Convoluted mass of blood vessels-both arteries and veins?
Arterio-Venous Malformation
-
Like England of old, this type of neoplasm is notorious for colonizing?
Metastatic Carcinoma
-
Enlarged ventricles without plugs or pressure?
Non-obstructive Hydrocephalus
-
One of their effects is to affect brain tissue by compressing brain tissue?
Extracerebral Hemorrhagic
-
Ruptured arteries of the pia bleed into this space?
Subacrachnoid
-
This glioma is the most common, most benign, and slow growing- a good one to choose if you must?
Astrocytoma
-
Distruption of blood flow through the mesial distribution of teh PCA may result in damage to this Brodmanns Area?
Brodmanns Area 17
-
The destruction of brain tissue by purulent by-productions of a bacterial infection?
Brain abscess
-
The location of this neoplasm would be identified more easily than others from observation along?
Meningomas
-
Smooth muscle may underlie these temporary disturbances-dizziness, numbness, slurring?
TIA (Transcient Ischemic Attacks)
-
This dense band of fibers is supplied by small penetrating arteries, contralateral limbs would become spastic if it was damaged?
Internal Capsule
-
Inside or outside of this membrane is the defining difference intracerebral or extracerebral'?
Pia Mater
-
This neoplasm would be your "last choice" if the choice was yours to make?
Glioblastoma Multiforme
-
LLesions in this gyrus would result in disturbed langauge comprehension and and formation?
Left superior temporal gyrus
-
Blocking this long, narrow, "waterway" can cause hydrocephalus?
Aquaduct of Sylvius
-
Possibly a life long project, building this plug on site can cause a brain attack?
Thrombus
-
Name the two major types - causes- of strokes. Which involves the presence of a "plug"? WHich involves a rupture or "leak"?
- "plug" Occlusive
- "Leak" Hemorrhagic
-
In a hemorrhagic stroke, brain tissue is deprived of blood beyond the rupture - what two other mechanisms for damage to brain tissue occur with a hemorrhagic stroke?
- Contact with blood - Intracerebral
- Hemorrhage and compression of brain tissue - extracerebral
-
Brain tissue deprived of blood initially suffers from....
Ischemia
-
Brain tissue that is no longer viable after being deprived of blood for too long is called...?
Necrotic, a lesion, an infarct
-
What is the difference between a TIA, RIND, PRIND
1. Which term might be considered "all inclusive"
2. Which lasts longer?
3. Which one "by definition" resolves with no lasting damage?
-
What are the sequelae that contribute to generalized impairment following a stroke?
Edema, diaschisis, excess neurotransmitter release, reduced blood flow
-
What is the difference between occlusive and hemorrhagic strokes versus hypoperfusion?
1. Do all result in deprivation of blood to brain tissue?
2. Do all have "geographic" restrictions- they only occur in certain areas?
3. Do all always involve widespread areas of damage?
-
What is the defining difference - the boundary- between intracerebral and extracerebral hemorrhages?
Inside vs. outside the pia mater
-
What are two major types of hemorrhages- referring to their underlying causes?
Spontaneous vs. Traumatic
-
What are the similarities/difference between intra-and extracerebral hemorhhages in their mechanisms for damage?
1. Which involves loss of blood supply?
2. Which involves direct contact with blood?
3. Which involves compression of brain tissue?
- 1. Both
- 2. Intracerebral
- 3. Extracerebral
-
What are the factors that affect the "symptom course" or the progression of symptoms associated with tumors/neoplasms?
1.
2.
3.
- 1. Size - the larger the tumor, the more likely effects are generalized.
- 2. Rate of growth - the faster the rate of growth, the more quickly effects will become generalized
- 3. Location - the deeper the tumor, the more likely effects are generalized
-
What are three mechanisms for the damaging effects of tumors?
1.
2.
3.
- 1. increased permeability of surrounding blood vessels
- 2. displacement/compression of blood vessels
- 3. displacement/compression of brain tissue
-
How are an astrocytomas and glioblastoma multiforme alike? How are they different?
1.
2.
- 1. They are both gliomas
- 2. One is benign (astrocytoma), and one is malignant (glioblastoma multiforme)
-
Which type of hydrocephalus does NOT involve increased intracranial pressure? Why?
Non-obstructive because the atrophy and loss of resilience in brain tissue allows expansion of the ventricles
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