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Questions and Answers
Which of the following is NOT a common cause of hemorrhagic stroke?
Which of the following is NOT a common cause of hemorrhagic stroke?
What is the name of the arterial network at the base of the brain that supplies blood to the cerebrum?
What is the name of the arterial network at the base of the brain that supplies blood to the cerebrum?
Which type of stroke is characterized by a blood clot forming within a cerebral vessel?
Which type of stroke is characterized by a blood clot forming within a cerebral vessel?
What are the primary types of ischemic strokes?
What are the primary types of ischemic strokes?
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What is the name of the process that narrows blood vessels due to fatty plaque buildup?
What is the name of the process that narrows blood vessels due to fatty plaque buildup?
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What is the main difference between an embolic stroke and a thrombotic stroke?
What is the main difference between an embolic stroke and a thrombotic stroke?
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Which of the following is NOT a typical location for a stroke within the brain?
Which of the following is NOT a typical location for a stroke within the brain?
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What is the approximate percentage of strokes that are ischemic in nature?
What is the approximate percentage of strokes that are ischemic in nature?
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Which of these options are NOT a direct consequence of blood vessel rupture in hemorrhagic stroke?
Which of these options are NOT a direct consequence of blood vessel rupture in hemorrhagic stroke?
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What is the primary function of the internal carotid arteries?
What is the primary function of the internal carotid arteries?
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Which arteries are included in the carotid system that supplies blood to the brain?
Which arteries are included in the carotid system that supplies blood to the brain?
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Where does the left common carotid artery originate from?
Where does the left common carotid artery originate from?
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What is the name of the anastomotic circle formed by the terminal branches within the cranial vault?
What is the name of the anastomotic circle formed by the terminal branches within the cranial vault?
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What is the primary pathway for blood to reach the brain from the heart?
What is the primary pathway for blood to reach the brain from the heart?
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Which arteries do the vertebral arteries pair with in the brain's blood supply system?
Which arteries do the vertebral arteries pair with in the brain's blood supply system?
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How many common carotid arteries are there in total in the human body?
How many common carotid arteries are there in total in the human body?
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Which arteries supply the majority of the cerebrum?
Which arteries supply the majority of the cerebrum?
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What is the primary risk factor for hemorrhagic stroke?
What is the primary risk factor for hemorrhagic stroke?
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What is a common symptom at the onset of a cerebral hemorrhage?
What is a common symptom at the onset of a cerebral hemorrhage?
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What does the 'A' in F.A.S.T. stand for when assessing for a stroke?
What does the 'A' in F.A.S.T. stand for when assessing for a stroke?
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What characterizes a Transient Ischemic Attack (TIA)?
What characterizes a Transient Ischemic Attack (TIA)?
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What risk is associated with a Transient Ischemic Attack (TIA)?
What risk is associated with a Transient Ischemic Attack (TIA)?
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What is the most common cause of an embolic stroke?
What is the most common cause of an embolic stroke?
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What characterizes the ischemic penumbra in the context of a stroke?
What characterizes the ischemic penumbra in the context of a stroke?
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Which subtype of ischemic stroke involves small vessel disease?
Which subtype of ischemic stroke involves small vessel disease?
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What is oligemia in the context of ischemic stroke?
What is oligemia in the context of ischemic stroke?
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What role do regulatory T lymphocytes (Treg) play in stroke recovery?
What role do regulatory T lymphocytes (Treg) play in stroke recovery?
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During which condition might stroke be classified as stroke of undetermined etiology?
During which condition might stroke be classified as stroke of undetermined etiology?
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What is a common consequence of cellular death in the core area of an ischemic stroke?
What is a common consequence of cellular death in the core area of an ischemic stroke?
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Which of the following is NOT associated with small vessel disease?
Which of the following is NOT associated with small vessel disease?
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What process occurs when brain cells switch to anaerobic metabolism due to lack of oxygen?
What process occurs when brain cells switch to anaerobic metabolism due to lack of oxygen?
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What effect does lactic acid have on brain cells during ischemia?
What effect does lactic acid have on brain cells during ischemia?
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What is a major consequence of excessive intracellular calcium levels during excitotoxicity?
What is a major consequence of excessive intracellular calcium levels during excitotoxicity?
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Which of the following best describes excitotoxicity?
Which of the following best describes excitotoxicity?
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What ultimately occurs as a result of blood-brain barrier dysfunction during ischemic events?
What ultimately occurs as a result of blood-brain barrier dysfunction during ischemic events?
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Which two factors primarily determine the extent of cerebral damage following ischemia?
Which two factors primarily determine the extent of cerebral damage following ischemia?
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What is the role of proteases during excitotoxicity?
What is the role of proteases during excitotoxicity?
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What consequence arises from ATP-reliant ion transport pumps failing during ischemia?
What consequence arises from ATP-reliant ion transport pumps failing during ischemia?
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Study Notes
Stroke: Cerebrovascular Accident
- Stroke is an acute neurologic deficit caused by a vascular disorder injuring brain tissue.
- Stroke is a leading cause of mortality and morbidity in the United States.
Cerebral Circulation
- Blood flow to the brain is supplied by two internal carotid arteries (anteriorly) and vertebral arteries (posteriorly).
- The internal carotid artery branches into several arteries: ophthalmic, posterior communicating, choroidal, anterior cerebral, and middle cerebral.
- The brain is supplied by two systems of arteries: a vertebral system (paired vertebral arteries) and a carotid system (paired internal carotid arteries).
- The Circle of Willis is an anastomotic circle of arteries connecting the vertebral and carotid systems. It supplies most of the cerebrum's arterial blood.
Vertebral Arteries
- The approximate locations of V1 and V2 vertebral artery segments are shown (graphic included).
Branches of the Aorta
- The illustration depicts many major arteries branching off the aorta, including the common carotid arteries, vertebral arteries, and subclavian arteries. (graphic included)
- The right and left common carotid arteries differ in origin; the left arises from the aortic arch; the right from the brachiocephalic trunk.
Common Carotid Artery
- There is one common carotid artery on each side of the body.
- These arteries differ in origin.
- The left common carotid artery originates from the aortic arch within the superior mediastinum.
- The right common carotid artery originates from the brachiocephalic trunk posterior to the right sternoclavicular joint.
Carotid Artery Bifurcation
- A graphic displays a carotid artery bifurcation.
Arteries to the Brain
- The graphic shows major arteries supplying blood to the brain, including the vertebral artery, carotid artery, and arch of the aorta.
Brain Anatomy Structures
- A cross-sectional diagram of the brain labels various anatomical structures, including foramina, canals, and parts of the surrounding bone structure.
Blood Supply to the Brain
- The vertebral and internal carotid arteries travel up from the neck to the cranium.
- The terminal branches of these arteries create the Circle of Willis, an anastomotic circle.
- Branches from the Circle of Willis supply most of the cerebrum.
Major Arteries in the Brain
- A diagram illustrates the brain, highlighting sections of major arteries within the brain's structure(internal carotid artery, vertebral artery, anterior cerebral artery, middle cerebral artery, basilar artery).
Ischemic Stroke Classifications
- Ischemic stroke (85%): includes large-artery atherosclerosis, small-vessel occlusion, cardio-embolism, cryptogenic, other.
- Hemorrhagic stroke (15%): includes intracerebral hemorrhage, intracerebral hemorrhage, subarachnoid hemorrhage.
Lacunar Stroke
- A stroke within the deeper structures of the brain (thalamus, basal ganglia, or pons) is called a lacunar stroke.
Ischemic Stroke Types
- The graphic illustrates embolic, ischema, and athero-thrombotic ischemic stroke subtypes.
Ischemic Stroke Pathophysiology
- Ischemic strokes occur due to the disruption of blood flow in cerebral vessels.
- In the core area of stroke, reduced blood flow leads to cell death.
- The ischemic penumbra is the region surrounding the core with moderately reduced blood flow, potentially recoverable with prompt intervention.
- A range of factors initiate the ischemic cascade, such as excitotoxicity, oxidative stress, and microvascular injury.
- The extent of cerebral damage is determined by the degree and duration of ischemia.
Hemorrhagic Stroke Pathophysiology
- Hemorrhagic stroke is caused by bleeding into brain tissue.
- Blood vessel rupture can result in edema, compression of brain tissue.
- Hemorrhages can be due to hypertension, aneurysms, trauma, or drugs.
- Elevated pressure from brain swelling can cause secondary ischemia.
Classification of Hemorrhagic Stroke
- Intracerebral hemorrhage (ICH): Blood within brain substance.
- Subarachnoid hemorrhage (SAH): Blood accumulation around brain.
Hemorrhagic Stroke Symptoms
- A sudden, severe headache is a common symptom of hemorrhagic stroke.
- Loss of consciousness and contralateral hemiplegia (weakness on the opposite side of the body) can be seen in some situations.
Stroke Symptoms and Diagnosis
- F.A.S.T., a method of rapid stroke evaluation: Facial movements asymmetry, arm weakness, speech difficulties, time to call emergency services.
Transient Ischemic Attack (TIA)
- TIAs are ischemic cerebral neurologic deficits lasting less than 24 hours.
- They are analogous to "brain angina," offering a warning sign for potential stroke.
- The risk of stroke is highest immediately after a TIA.
Regulatory T Lymphocytes (Treg)
- Treg cells mitigate the enhanced production of TNF-α and IFN-γ.
- These cells are key mediators of the cerebroprotective effect, suppressing proinflammatory cytokines.
- Depletion leads to increased inflammatory brain damage.
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Description
Test your knowledge on the anatomy of strokes and their classifications. This quiz covers various aspects of hemorrhagic and ischemic strokes, including their causes, types, and the arterial networks involved in brain circulation. Challenge yourself and learn more about this critical health topic.