Types of Stroke

Questions and Answers

Which condition is indicated when thrombolytic treatment is contraindicated?

Focal cerebral ischaemia

Ischaemic stroke

Cerebral infarction

Haemorrhagic stroke (correct)

What is the primary cause of global cerebral ischaemia?

Severe hypotension or cardiac arrest (correct)

Extracranial vessel rupture

Localized blockage of a major artery

Traumatic brain injury

What is the principle characteristic of focal cerebral ischaemia?

Complete and prolonged ischemia affecting all brain tissue

Cessation of blood flow to a localized area of the brain (correct)

Reduction in blood supply to the whole brain

Diffuse cerebral swelling

Which area of the brain is most at risk during global cerebral ischaemia?

Regions bordered by two major arteries Signup and view all the answers

What is the potential result of severe neuronal injury from a severe ischaemic stroke?

Vegetative state or death Signup and view all the answers

How does cerebral infarction primarily affect brain tissue?

It results in focal brain necrosis affecting all tissue elements Signup and view all the answers

Which condition is characterized by a risk of watershed infarcts?

Global cerebral ischaemia Signup and view all the answers

Which of the following is NOT a typical outcome of mild ischaemic stroke?

Widespread neuronal injury Signup and view all the answers

Which of the following is NOT a cause of non-traumatic intracranial hemorrhage?

Traumatic injury Signup and view all the answers

What characterizes lobar hemorrhage related to cerebral amyloid angiopathy?

Amorphous pink deposit within arterioles Signup and view all the answers

Which statement about hypertensive intraparenchymal hemorrhage is correct?

Hyaline deposition in arterioles is a contributing factor. Signup and view all the answers

In the context of cerebrovascular disease, what is defined as an episode of acute neurological dysfunction persisting for at least 24 hours?

Cerebrovascular accident Signup and view all the answers

What underlying condition primarily contributes to Charcot-Bouchard microaneurysms?

Chronic hypertension Signup and view all the answers

Which of the following conditions is NOT considered a vascular cause of non-traumatic brain injury?

Neoplasm Signup and view all the answers

Which factor is associated with the rupture of small intraparenchymal vessels leading to a hemorrhagic stroke?

Amyloid deposition Signup and view all the answers

What is the role of systemic coagulation disorders in non-traumatic brain injury?

They can alter blood flow dynamics. Signup and view all the answers

What is the primary cause of in situ thrombosis leading to ischaemic stroke?

Atheroma Signup and view all the answers

Which factor is NOT a recognized risk factor for in situ thrombosis?

Obesity Signup and view all the answers

Which type of infarct is typically associated with embolism?

Non-haemorrhagic infarct Signup and view all the answers

What is the primary pathological change observed in lacunar infarcts?

Lake-like spaces due to occlusion Signup and view all the answers

Which of the following conditions is characterized by fibrinoid necrosis of vessels?

Hypertensive encephalopathy Signup and view all the answers

Which of the following statements about thrombolytic therapy is accurate?

It may cause reperfusion injury in ischaemic strokes. Signup and view all the answers

What is a common presentation of acute malignant hypertension?

Diffuse cerebral dysfunction with confusion Signup and view all the answers

Which statement reflects the effects of cerebral amyloid angiopathy?

It causes hemorrhagic strokes primarily in elderly individuals. Signup and view all the answers

What type of stroke is characterized by cessation or impairment of blood supply and oxygenation?

Ischaemic stroke Signup and view all the answers

Study Notes

Clinical Manifestation of Brain Injury

Depends on the site of brain injury, which depends on the vessel involved

Haemorrhagic Stroke

Rupture of CNS vessels: thrombolytic is contraindicated
Caused by rupture of small intraparenchymal vessels, leading to sudden onset of neurologic symptoms
Causes:
- Hypertension (~50%)
- Amyloid angiopathy
- Other vascular causes: vascular malformation, aneurysm, vasculitis
- Other non-vascular causes: neoplasms, systemic coagulation disorders

Ischaemic Stroke

Cessation/impairment of blood supply and oxygenation
Types:
- Global cerebral ischaemia: generalised reduction of cerebral perfusion
- Focal cerebral ischaemia: cessation of blood flow to localised area of the brain

Global Cerebral Ischaemia

Causes: cardiac arrest, shock, severe hypotension
Area at highest risk: zones bordered by two major arteries → watershed infarcts
Clinical syndrome depends on severity of insult
- Mild: transient confusion and complete recovery
- Severe: widespread neuronal injury leading to vegetative state or death

Focal Cerebral Ischaemia

Cerebral infarction: focal brain necrosis due to complete and prolonged ischaemia
Infarct types:
- Non-haemorrhagic or pale infarct: typically due to thrombosis
- Haemorrhagic or red infarct: typically due to emboli

Non-Traumatic Brain Injury

Cerebrovascular diseases (CVD): stroke
Clinical definition: an episode of acute neurological dysfunction presumed to be caused by ischaemia or non-traumatic haemorrhage, persisting ≥24 hours or until death
Causes:
- In situ thrombosis: atheroma
- Embolism from distant source
- Vasculitis: infection, primary vasculitis

Pathology Changes of Brain Infarct

Gross pathology and microscopy changes over time

Lobar Haemorrhage

Affecting cerebral lobes
Caused by deposition of Aβ amyloid on the wall of medium and small vessels of meningeal and cortical vessels → weak wall → rupture

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Description

This quiz covers the different types of stroke, including haemorrhagic and ischaemic stroke, and their clinical manifestations. It also discusses the implications of thrombolytic treatment and the effects of blood supply cessation.