Cerebrovascular Diseases PDF

# Cerebrovascular Disease ## Summary **Def:** Diseases of Blood vessels. **2 Main Categories** * **Ischemia** * Thrombotic * Embolic * **Hemorrhage** * Important type * Intra cerebral hemorrhage **SAQ** Mention 3 main pathogenic mechanisms of cerebrovascular diseases? 1. Thromb...

# Cerebrovascular Disease ## Summary **Def:** Diseases of Blood vessels. **2 Main Categories** * **Ischemia** * Thrombotic * Embolic * **Hemorrhage** * Important type * Intra cerebral hemorrhage **SAQ** Mention 3 main pathogenic mechanisms of cerebrovascular diseases? 1. Thrombotic occlusion leads to Ischemia 2. Embolic occlusion leads to Ischemia 3. Vascular rupture leads to Hemorrhage **1- Functional Hypoxia** * Brain doesn’t receive O2 * Causes 1. High altitude 2. Severe anemia 3. CO poisoning, cyanide poisoning **2- Ischemia** * Loss of blood supply to the tissue **SAQ** Mention two types of Ischemia? **Ischemia** **Global:** Affects All brain tissue * Due to: * Severe systemic hypotension * Cardiac arrest & shock * **Gross:** *SA* * **Microscopic:** *SA* * Brain: swollen sulci, narrowed gyri, wide * 12-24h- Acute neuronal cell change (*Red neurons*) * 24 hours -2 weeks- Tissue necrosis, macrophage, gliosis * After 2 weeks- Removal of all necrotic tissue (*Gliosis*) **Focal:** Part of brain tissue * One blood vessel has been obstructed. * May be modified by (Collateral arteries) * Circle of Willis * The focal ischemia produce **Reperfusion injury** - sudden return blood supply to ischemic brain area leads to damage to brain tissue. ## Cerebral Infarction: Necrosis due to Ischemia. * An embolic infarction forms outside the brain and is most common. It comes from the heart and the embolism impacts the: * **Middle Cerebral Artery**: Most common * **More Common**: Embolic, Thrombotic ## Intracranial Hemorrhage: Hemorrhage within brain caused by: 1. **Hypertension**: e.g, Intracerebral Hemorrhage 2. **Arteriovenous Malformations**: e.g. Subarachnoid Hemorrhage (Berry aneurysms) 3. **Cavernous Malformations** 4. **Tumors**: e.g, Epidural, Subdural, or Subarachnoid Hemorrhage ## Subarachnoid Hemorrhage: It’s due to rupture of Saccular (Berry) Aneurysm **The most common cause of Subarachnoid Hemorrhage** **Case** Patient 35 age have severe sudden headache and show hemorrhage in subarachnoid space. **Diagnosis?** Subarachnoid hemorrhage. **SAQ**: Very Important * Congenital defect in media of blood vessels and over time (Berry aneurysm) is formed. ## Vascular Malformations: Classified to 4 Principal Types: * **Disorganized tissue** * **SAQ** * **Arteriovenous Malformations (AUMs):** Most dangerous & most common type * **Cavernous Malformations** * **Capillary Malformations** * **Venous Angiomas** **Q**: Enumerate U principal types of vascular malformations and mention the most dangerous? **Made by: Ahmed Ghonim**