01 November 2006

Vascular Neurology 101

Since a big part of my job is reviewing the charts of children who have been diagnosed with stroke, I thought it was time to put together a little quiz.

Define each of the below and label them either as 1) a stroke risk factor or 2) a stroke sign/symptom:

a. eclampsia
b. HLHS (hypoplastic left heart syndrome)
c. PFO (patent ferman ovalae)
d. PDA (patent ductus arteriosis)
e. moyamoya
f. AVM (ateriovascular malformation)
g. Otitis media
h. Hemiparesis
i. dysmetria
j. ataxia
k. aphasia
l. dysarthia
m. vasospasm
n. mastoiditis

Which pair of arteries feeds the PCAs (posterior cerebral arteries)?
Which pair of arteries feed the ACAs/MCAs (anterior cerebral and middle cerebral)?
What arterty does the PICA (posterior inferior cerebellar artery) originate from?
Where are the watershed regions located?
What is the most common pattern of ischemia for cardioembolic stroke?
What is the difference between stenosis and coarction?

For the answers... check the comments.


design42 said...

a. eclampsia is convulsions during pregnancy.
b. HLHS is a congenital heart defect where the left ventricle essentially fails to form. These children generally have a series of surgeries to establish a Fontan physiology.
c. PFO is a hole in the septum dividing the two atria of the heart.
d. PDA is when the duct btw the pulmonary artery and aorta fails to close at birth
e. moymoya is a vascular disease characterised by stenosis of the M1 segment of the cerebral arteries and growth of many tiny collateral vessels
f. AVM generally involves vessel malformations such as arteries connecting directly to veins
g. otitis media is the fancy term for ear infection
h. hemiparesis is one-sided weakness
i. dysmetria is the loss of ability to gauge muscular motion distances
j. ataxia is alteration of gait, usually due to balance issues (ie cerebellar injury)
k. aphasia is a cognitive impairment in the ability to speak or comprehend speech.
l. dysarthia is the loss of motor coordination to articulate speech
m. vasospasm is the extreme and prolonged contraction of the smooth muscle around a blood vessel
n. mastoiditis is an infection of the mastoid (just behind your ears).

design42 said...

Stroke risk factors: b,e,f,g,m,n
Stroke symptoms: h,i,j,k,l

c is a topic of current research
a maybe for neonatal

design42 said...

The PCAs are fed by the vertebral arteries.

The ACAs/MCAs are fed by the internal carotid arteries.

The PICA originated from the vertebral arteries.

The watershed regions are located in the regions where the circulation overlaps between cerebral arteries. ie, where the MCA tapers off and the ACA begins or btw the MCA and PCA territories.

The most common pattern for cardioembolic stroke is a scatter of small ischemic infarcts.

Coarctation is actually stenosis, but it's stenosis of the aorta.

miss akay said...

nice work! you'll be in great shape for neuro, when you get to medical school. :)