Podcast
Questions and Answers
Which condition involves the bulging of a weakened arterial wall, potentially leading to rupture and hemorrhage?
Which condition involves the bulging of a weakened arterial wall, potentially leading to rupture and hemorrhage?
- Atherosclerosis
- Stenosis
- Aneurysm (correct)
- Dissection
A patient presents with symptoms of reduced blood flow in the carotid artery. What arterial condition is most likely contributing to these symptoms?
A patient presents with symptoms of reduced blood flow in the carotid artery. What arterial condition is most likely contributing to these symptoms?
- Venous Insufficiency
- Atherosclerosis (correct)
- Lymphatic Obstruction
- Arterial Dissection
Which of the following arterial conditions involves the tearing of the arterial wall, potentially leading to the formation of a false lumen?
Which of the following arterial conditions involves the tearing of the arterial wall, potentially leading to the formation of a false lumen?
- Vasospasm
- Arteriosclerosis
- Aneurysm
- Dissection (correct)
A 60-year-old patient with a history of hypertension and smoking is diagnosed with an arterial condition. Which of the following is most likely to be the primary underlying factor contributing to this condition?
A 60-year-old patient with a history of hypertension and smoking is diagnosed with an arterial condition. Which of the following is most likely to be the primary underlying factor contributing to this condition?
A physician orders diagnostic imaging to evaluate a patient suspected of having a cerebral vascular accident (CVA). Which of the following arterial conditions would this imaging be MOST helpful in identifying?
A physician orders diagnostic imaging to evaluate a patient suspected of having a cerebral vascular accident (CVA). Which of the following arterial conditions would this imaging be MOST helpful in identifying?
Which of the following arteries is NOT part of the vertebrobasilar system within the Circle of Willis?
Which of the following arteries is NOT part of the vertebrobasilar system within the Circle of Willis?
A patient presents with a sudden loss of balance and coordination. Which artery is MOST likely affected based on these symptoms?
A patient presents with a sudden loss of balance and coordination. Which artery is MOST likely affected based on these symptoms?
Aneurysms are MOST commonly found in which location within the cerebral vasculature?
Aneurysms are MOST commonly found in which location within the cerebral vasculature?
Which artery would MOST likely be affected given the lack of collateral perfusion?
Which artery would MOST likely be affected given the lack of collateral perfusion?
A patient is diagnosed with arteriovenous malformation. Which best describes this condition?
A patient is diagnosed with arteriovenous malformation. Which best describes this condition?
Atherosclerosis is MOST likely to develop at which point in the cerebral vasculature system?
Atherosclerosis is MOST likely to develop at which point in the cerebral vasculature system?
Following a traumatic brain injury, a patient exhibits signs of ischemia in the occipital lobe. Which artery is MOST likely compromised?
Following a traumatic brain injury, a patient exhibits signs of ischemia in the occipital lobe. Which artery is MOST likely compromised?
Upon reviewing an angiogram, a radiologist identifies a blockage in the M1 segment of the middle cerebral artery. Which region of the brain is MOST immediately at risk of infarction?
Upon reviewing an angiogram, a radiologist identifies a blockage in the M1 segment of the middle cerebral artery. Which region of the brain is MOST immediately at risk of infarction?
Which of the following arteries provides blood supply to the inner ear?
Which of the following arteries provides blood supply to the inner ear?
A patient presents with vision problems after a stroke. Which artery is MOST likely involved?
A patient presents with vision problems after a stroke. Which artery is MOST likely involved?
Which condition increases the risk of both hemorrhagic and occlusive strokes?
Which condition increases the risk of both hemorrhagic and occlusive strokes?
A patient exhibits a sudden, severe headache, and a CT scan reveals diffuse subarachnoid hemorrhage and hydrocephalus. An angiogram identifies a saccular berry aneurysm in the anterior communicating artery. What is the most likely underlying cause of the aneurysm?
A patient exhibits a sudden, severe headache, and a CT scan reveals diffuse subarachnoid hemorrhage and hydrocephalus. An angiogram identifies a saccular berry aneurysm in the anterior communicating artery. What is the most likely underlying cause of the aneurysm?
Occlusion of the lenticulostriate arteries, which branch off the proximal M1 segment of the MCA, would primarily affect which structure?
Occlusion of the lenticulostriate arteries, which branch off the proximal M1 segment of the MCA, would primarily affect which structure?
Which vascular structure supplies the basal ganglia, limbic structures, and anterior limb of the internal capsule?
Which vascular structure supplies the basal ganglia, limbic structures, and anterior limb of the internal capsule?
A patient experiences cardiac arrest leading to a lack of oxygenated blood to the brain. This condition is best described as:
A patient experiences cardiac arrest leading to a lack of oxygenated blood to the brain. This condition is best described as:
What is the primary difference between ischemia and infarction in the context of cerebrovascular accidents?
What is the primary difference between ischemia and infarction in the context of cerebrovascular accidents?
Which arteries provide blood supply to the thalamus and posterior limb of the internal capsule?
Which arteries provide blood supply to the thalamus and posterior limb of the internal capsule?
What pathological mechanism underlies lacunar infarctions?
What pathological mechanism underlies lacunar infarctions?
A patient presents with a constellation of symptoms, suggesting a CVA. Which of the following symptoms most strongly suggests a hemorrhagic stroke rather than an occlusive stroke?
A patient presents with a constellation of symptoms, suggesting a CVA. Which of the following symptoms most strongly suggests a hemorrhagic stroke rather than an occlusive stroke?
Which condition involves bleeding into the wall of a blood vessel?
Which condition involves bleeding into the wall of a blood vessel?
Occlusion of lenticulostriate branches off the M1 segment of the middle cerebral artery (MCA) would most likely result in which of the following?
Occlusion of lenticulostriate branches off the M1 segment of the middle cerebral artery (MCA) would most likely result in which of the following?
A patient presents with right-sided weakness, slurred speech, and an extension plantar response (Babinski's sign). The right facial weakness spares the forehead. Which vascular event is the most likely explanation?
A patient presents with right-sided weakness, slurred speech, and an extension plantar response (Babinski's sign). The right facial weakness spares the forehead. Which vascular event is the most likely explanation?
A patient exhibits weakness in the left leg and mild weakness in the left arm, accompanied by a positive Babinski's sign on the left side. Mild dysarthria is also noted. Which cerebral artery is most likely affected by an infarct?
A patient exhibits weakness in the left leg and mild weakness in the left arm, accompanied by a positive Babinski's sign on the left side. Mild dysarthria is also noted. Which cerebral artery is most likely affected by an infarct?
A patient presents with blurry vision and a right visual field defect, but no somatosensory or motor deficits. Which cerebral artery is most likely affected by an infarct?
A patient presents with blurry vision and a right visual field defect, but no somatosensory or motor deficits. Which cerebral artery is most likely affected by an infarct?
Watershed infarcts are most likely to occur due to hypo-perfusion in the border zones between major cerebral arteries. Which of the following clinical presentations would be most suggestive of a watershed infarct between the ACA and MCA?
Watershed infarcts are most likely to occur due to hypo-perfusion in the border zones between major cerebral arteries. Which of the following clinical presentations would be most suggestive of a watershed infarct between the ACA and MCA?
Which of the following best explains why the internal capsule is particularly vulnerable to the effects of hemorrhage or infarction?
Which of the following best explains why the internal capsule is particularly vulnerable to the effects of hemorrhage or infarction?
If a patient presents with pure hemiparesis (weakness on one side of the body) without any sensory loss, which of the following locations is most likely the site of a small lacunar infarct?
If a patient presents with pure hemiparesis (weakness on one side of the body) without any sensory loss, which of the following locations is most likely the site of a small lacunar infarct?
A patient presents with pure hemisensory loss (sensory loss on one side of the body) without any motor deficits. Which of the following locations is most likely the site of a small lacunar infarct?
A patient presents with pure hemisensory loss (sensory loss on one side of the body) without any motor deficits. Which of the following locations is most likely the site of a small lacunar infarct?
What is the most likely diagnosis for a patient exhibiting progressive dementia, cranial nerve palsies, dysarthria, dysphagia, a positive gag reflex, and emotional imbalance, stemming from a series of small lacunar infarcts?
What is the most likely diagnosis for a patient exhibiting progressive dementia, cranial nerve palsies, dysarthria, dysphagia, a positive gag reflex, and emotional imbalance, stemming from a series of small lacunar infarcts?
Which of the following is the primary mechanism by which astrocytes contribute to the blood-brain barrier (BBB)?
Which of the following is the primary mechanism by which astrocytes contribute to the blood-brain barrier (BBB)?
Which of the following describes the role of pericytes in maintaining the blood-brain barrier (BBB)?
Which of the following describes the role of pericytes in maintaining the blood-brain barrier (BBB)?
The exchange of substances across the blood-brain barrier (BBB) is highly regulated. Which of the following mechanisms allows for the transport of lipid-soluble molecules across the BBB?
The exchange of substances across the blood-brain barrier (BBB) is highly regulated. Which of the following mechanisms allows for the transport of lipid-soluble molecules across the BBB?
The cerebral vein of Galen drains into which of the following?
The cerebral vein of Galen drains into which of the following?
What is the significance of the 'empty delta sign' in the context of cerebral venous drainage?
What is the significance of the 'empty delta sign' in the context of cerebral venous drainage?
The inferior anastomotic vein of Labbé primarily drains into which of the following sinuses?
The inferior anastomotic vein of Labbé primarily drains into which of the following sinuses?
Flashcards
Cerebrovascular Accident (CVA)
Cerebrovascular Accident (CVA)
Brain blood vessel problems. Can cause stroke-like symptoms
Aneurysm
Aneurysm
Weakened artery wall bulges, risking rupture and bleeding
Atherosclerosis
Atherosclerosis
Plaque buildup narrows/blocks arteries, reducing blood flow
Arterial Dissection
Arterial Dissection
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Arterial vasculature
Arterial vasculature
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Dissection (Vascular)
Dissection (Vascular)
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Arteriovenous Malformation (AVM)
Arteriovenous Malformation (AVM)
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Infarction
Infarction
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Ischemia
Ischemia
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Hypoxia
Hypoxia
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Cerebral Infarction
Cerebral Infarction
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Occlusive Stroke
Occlusive Stroke
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Hemorrhagic Stroke
Hemorrhagic Stroke
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Infarction and Ischemia
Infarction and Ischemia
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Circle of Willis
Circle of Willis
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Basilar Artery
Basilar Artery
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Anterior Cerebral Artery (ACA)
Anterior Cerebral Artery (ACA)
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Middle Cerebral Artery (MCA)
Middle Cerebral Artery (MCA)
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Posterior Cerebral Artery (PCA)
Posterior Cerebral Artery (PCA)
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Posterior Communicating Artery
Posterior Communicating Artery
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Hemorrhage in Brain
Hemorrhage in Brain
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Lacunar Infarcts
Lacunar Infarcts
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État Lacunaire
État Lacunaire
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Hemiparesis/Hemiplegia
Hemiparesis/Hemiplegia
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Babinski's Sign
Babinski's Sign
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ACA Infarct Symptoms
ACA Infarct Symptoms
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PCA Infarct Symptoms
PCA Infarct Symptoms
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Watershed Infarct
Watershed Infarct
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Venous System of Brain
Venous System of Brain
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Superior Sagittal Sinus
Superior Sagittal Sinus
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Blood-Brain Barrier (BBB)
Blood-Brain Barrier (BBB)
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Cerebrospinal Fluid (CSF) Functions
Cerebrospinal Fluid (CSF) Functions
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Study Notes
- The lecture covers the arterial and venous vasculature of the brain, examples of CVA (Cerebrovascular Accident), and the blood-brain barrier
Arterial Vasculature
- The arterial supply to the brain comes from the vertebral and basilar arteries, and the internal carotid arteries
- The vertebral and basilar arteries supply the cerebellar, cerebral, spinal, and pontine regions
- The internal carotid arteries primarily supply the cerebral regions
- The vertebral arteries merge to form the basilar artery
- Cerebral arteries make up parts of the Circle of Willis
Circle of Willis
- An anastomosis of vessels
- Consists of the vertebral and basilar artery system, and the internal carotid artery system
- Vertebrobasilar System consists of:
- Posterior cerebral artery (PCA)
- Superior cerebellar artery (SCA)
- Anterior inferior cerebellar artery (AICA)
- Posterior inferior cerebellar artery (PICA)
- Anterior and posterior spinal arteries
- Internal Carotid Artery Consists of
- Posterior communicating artery
- Middle cerebral artery (MCA)
- Anterior communicating artery
- Anterior cerebral artery (ACA)
- Ophthalmic artery
- Internal Carotid System
- Includes :
- Internal carotid artery
- Ophthalmic artery
- Posterior communicating artery
- Anterior communicating artery
- Anterior cerebral artery (A1, A2 segments)
- Middle cerebral artery (M₁ proximal branch, M₂ segments)
- Lenticulostriate arteries
- Anterior choroidal arteries which supply the basal ganglia, hippocampus, and posterior limb of the internal capsule
- Vertebro-basilar System
- Includes Vertebral artery, Basilar artery, Spinal artery, Posterior inferior cerebellar artery, Anterior inferior cerebellar artery, Superior cerebellar artery and Posterior cerebral artery (P1, P2 segments)
- The anterior choroidal artery, thalamoperforator, thalamogeniculate and posterior choroidal artery supply blood to the thalamus and the posterior limb of the internal capsule
- Occlusion of end vessel causes focal ischemia
- Hypo-perfusion causes border zone infarct
- Proximal limb weakness can be (ACA / MCA)
- Aphasia can be (PCA / MCA)
Venous Vasculature
- Veins eventually drain into the internal jugular vein
- Veins that participate in venous drainage include
- Inferior sagittal sinus, superior anastomotic vein of Trolard, inferior anastomotic vein of Lobe, and torcula or confluence of sinuses
- Superficial veins include superior sagittal sinus and cavernous sinus
- Deep veins include Great vein of Galen
- Superior Sagittal, Inferior Sagittal and Straight Sinuses
- Cerebral Veins
- Superior petrosal sinus, inferior petrosal sinus
- Superior anastomotic vein of Trolard, inferior anastomotic vein of Labbe and Superficial middle cerebral vein
- Cerebral vein of Galen and Basil vein of Rosenthal
Blood Brain Barrier (BBB)
- Formed by endothelial cells with tight junctions, induced by astrocytes
- Pericytes support the BBB
- Metabolic barrier (MAO)
- Functions of the CSF
- Shock absorber
- Removal of metabolites
- pH buffer
- Blood and CSF exchange
- Lipid soluble diffusion
- Receptor mediated transport
- Ion channel diffusion
Pathology
- Examples of CVA
- Aneurysm
- Atherosclerosis
- Dissection
- Arterio-Venous Malformation
- Infarction
- Atherosclerosis often occurs at bifurcations in major vessels and the Circle of Willis, and can cause plaque deposition on the vessel wall
- Within the Circle of Willis, there is anastomosis providing collateral supply, but the basilar artery lacks collateral perfusion
- Aneurysms are "baloonings"
- Berry aneurysms occur at the base of the brain, in particular at the Circle of Willis
- Micro-aneurysms are intra-cerebral
- Dissections involve bleeding within the vessel
- Internal carotid
- Arteriovenous malformation is intra-cerebral
- Atherosclerosis
- causes occlusive stroke, infarction and hemorrhage
- Aneurysm and dissection
- cause hemorrhage and infarction (death of tissue)
- Ischemia is lack of blood flow to brain
- Hypoxia is lack of oxygenated blood in brain
- Infarction leads to death of brain
Cerebrovascular Accident or CVA
- It is a risk with many complications, including:
- Occlusive stroke is either thrombolytic or embolytic from a closure of vessels
- Hemorrhagic stroke is from rupture of blood vessels
Global Cerebral Ischemia
- Diffuse hypoxic and/or ischemic encephalopathy
- Causes cardiac arrest
- Shock
- Hypo-perfusion
Focal Cerebral Ischemia
- Caused by the following:
- Embolism
- Thrombus
- Vasculitis
- Lacunar infarction in Intra-cerebral Hemorrhage Note: penetrating arteries to thalamus, basal ganglia and internal capsule are END arteries so no collateral perfusion
- Small lacunes cause
- Posterior limb: Pure hemi-paresis no sensory loss, descending motor
- Ventral posterior nucleus of the thalamus, pure Hemisensory loss, ascending sensory
- Etat lacunaire: progressive dementia, cranial nerve palsies, dysarthria, dysphagia, (+) gag reflex, emotional imbalance
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Description
This lecture explores the arterial and venous vasculature of the brain, including the vertebral, basilar, and internal carotid arteries. It also covers the Circle of Willis and examples of Cerebrovascular Accidents (CVA). Key concepts such as the blood-brain barrier are discussed.