What type of event is of sudden onset, which may also refer to the early "signaling" symptoms of a chronic disease?
What type of onset is gradual, "sneaky", and has subtle signs?
What type of stroke occurs when an artery is blocked and part of the brain loses its blood supply?
If this type of occlusion/stroke lasts more than 3 to 5 minutes, it may result in permanent damage or death of brain tissue.
Death of brain tissue is called?
Ischemic strokes may be cause by
What is a "plug" of material - plaque, platelets, bacteria, etc.?
What accumulates at the site of occlucions (larger arteries, bends, and bifurcations most likely sites)?
What is usually a blood clot that forms where fatty arteriosclerotic deposits have narrowed the lumen of the artery?
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?
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.
1. have a more sudden onset
2. have warning signsthat may be absent or almost undetectable
The difference between thrombotic and embolic events.
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?
What is tissue whose functioning is affected by loss of oxygen-supply ("hungry")?
What is tissue that has died and is no longer viable (dead)?
What is an area of damaged, necrotic tissue?
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?
What is diminished function of areas that are remote from the site of injury, but connected by the nerve fibers?
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?
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?
What is considered to be not a "true" stroke?
What is decresed blood flow to peripheral areas due to:
1. lowered blood pressure
2. lowered blood volume
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?
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.
_____ _____ are caused by rupture or leakage of cerebral blood vessels.
Cerebral hemorrhages may be the result of
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?
What is the pooling of blood from a ruptured blood vessel?
Bleeding that is inside the brain as the result of a TBI or resulting from microaneurysms in "penetrating arteries"?
Blood on the surface of the brain that is most commonly from rupture of blood vessels or pia?
This type of bleeding most often involves th einternal carotid, anterior cerebral, middle cerebral, and basilar artery?
Which hematoma is like a sponge of blood?
Which type of hematoma is like a pocket of blood?
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.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?
What treatment is used for a hemorrhage?
1. decrease the blood pressure
2. increase blood clotting (by using coagulants)
What treatment is used for a occlusive/ischemic stroke?
1. decrease blood clotting (anti-coagulants)
For which type of acute stroke is the greatest recovery in the first 3-4 weeks?
For which type of acute stroke is gradual deceleration of recovery curve until stable?
For which type of acute stroke is recovery the greatest for middle-severity range?
For which type of acute stroke is there little recovery in the first 4-8 weeks?
For which type of acute stroke is it followed by rapid recovery?
For which type of acute stroke is there rapid recovery but then it slows and stabilizes?
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 effect the CNS and may be localized or generalized depending on the degree of and "interaction" among various factors:
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. 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)?
Which herniation is most common, least ominous, and may be assymptomatic, unless anterior cerebral artery is compressed resulting in contralateral numbness in leg?
Which herniation involves the mesial temporal lobe pushed "horizontally" into space between cerebrum and cerebellum?
Which herniation stretches, disorts tissue/blood vessels near the base of the brain and the brainstem Ischemia may compromise life functions?
Which herniation swells at the apex of the brain pushing the brain/brainstem through the foramen magnum? (may compromise brainstem and life functions?
Which herniation consists of the swelling of the cerebellum, pons, medulla, and pushes the cerebrallar tonsils through the foramen magnum? (may compromise life functions)?
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?
Which type of Gliomas may be dangerous if it is in a location that poses a problem?
Which Gliomas has symptoms that may appear over 5-6 years and post operative survival is good 10 years +?
Which Gliomas is the next most common and is seen in ages 40-55, is one of the most malignant and rapidly growing tumors?
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)?
This is a tumor that arises from the meninges - often on the dura?
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?
_______ ______ 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.
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.
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)?
______ _____ is caused by obstruction of the interventricular passageways through which CSF circulates.
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.
A generic label for several conditions that cause ventricular enlargement but do not involve obtruction of interventricular passageway.
An enlargement or the ventricles that does not involve increased intracranial pressure?
Common example of this condition would be "cerebral atrophy" - surrounding brain tissue looses viability, become "mushy", and no longer.
This is a primary medical treatment for ostructive hydrocephalus.
This is a secondary bacterial infection, bacterial will be transmitted from extracerebral infection sites.
The introduction of bacteria, fungus, or parasites into brain tissues from a primary infection site elsewhere in the body.
The pia, arachnoid, and CSF become infected with bavteria, causing inflammation, swelling, and fluid exudate from the meninges.
Treatment for ____ ____ is antibiotics and draining of abscess.
Symptoms from this infection includes faver, chills, headache, stiff neck, drowsiness/lethargy, and papilledema.
What does the acronym FAST stand for?
Face, Arms, Speech, and Time
Pressuring the brain through this large opening can threaten life?
Convoluted mass of blood vessels-both arteries and veins?
Like England of old, this type of neoplasm is notorious for colonizing?
Enlarged ventricles without plugs or pressure?
One of their effects is to affect brain tissue by compressing brain tissue?
Ruptured arteries of the pia bleed into this space?
This glioma is the most common, most benign, and slow growing- a good one to choose if you must?
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?
The location of this neoplasm would be identified more easily than others from observation along?
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?
Inside or outside of this membrane is the defining difference intracerebral or extracerebral'?
This neoplasm would be your "last choice" if the choice was yours to make?
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?
Name the two major types - causes- of strokes. Which involves the presence of a "plug"? WHich involves a rupture or "leak"?
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....
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?
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?
What are the factors that affect the "symptom course" or the progression of symptoms associated with tumors/neoplasms?
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. 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. 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