Term
Non-hemorrhagic infarct:
Gross Examination
• First 6 hours |
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Definition
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Term
Non-hemorrhagic infarct:
Gross Examination
• 48 hours: |
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Definition
| tissue is pale, soft, and swollen |
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Term
Non-hemorrhagic infarct:
Gross Examination
• 10 days to 3 weeks |
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Definition
| the lesion is a cystic cavity holding liquefied tissue |
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Term
Non-hemorrhagic infarct:
Gross Examination
• 2-10 days: |
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Definition
| Brain is gelatinous and friable. Border between normal and abnormal tissue becomes more distinct. |
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Term
• Non-hemorrhagic infarct
Microscopic: After the first 12 hours: |
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Definition
| Neurons show injury (red neurons) |
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Term
• Non-hemorrhagic infarct
Microscopic: Up to 48 hours: |
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Definition
| Neutrophilic infiltration increases and peaks |
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Term
• Non-hemorrhagic infarct
Microscopic: 48+ hours: |
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Definition
| Phagocytic cells derived from circulating monocytes and microglial cells are seen and over the next 2-3 weeks are the predominant cell type. |
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Term
• Non-hemorrhagic infarct
Microscopic: about 1 week after the event |
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Definition
| • Reactive astrocytosis can be seen |
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Term
• Non-hemorrhagic infarct
Microscopic: Within Months after event: |
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Definition
| The astrocytic response abates leaving in its wake a meshwork of glial fibers , new capillaries, and perivascular connective tissue, Residual cavity |
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Term
| • Neurons which are very susceptible to the effects of ischemia: |
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Definition
o Pyramidal cells in CA1 of the hippocampus
o Purkinje cells of the cerebellum
o Cortical pyramidal neurons |
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Term
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Definition
| o Syndromes: Pure motor hemiparesis, pure sensory stroke, ataxic hemiparesis, dysarthria & clumsy hand |
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Term
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Definition
| o CT shows lens-shaped (biconcave) mass |
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Term
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Definition
| o lucid interval for several hours before onset of neurological symptoms (HA, vomiting, drowsiness, confusion, aphasia, seizures, hemiparesis) |
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Term
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Definition
| o CT shows crescent-shaped mass |
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Term
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Definition
| o Usually associated w/ head trauma, lateral skull fracture, and tearing of the middle meningeal artery & vein |
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Term
| Subdural -->chronic hematoma |
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Definition
o Hematoma breaks down and organizes over time (clot lysis, fibroblast growth, & development of hyaline tissue) → hematoma is attached to dura by fibrous tissue
o Can be chronic with either a trivial injury and lack of symptoms for weeks or repeat bleeding from thin-walled vessels of granulation tissue that body puts there for repair (risk of repeat bleed greatest in 1st several months) |
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Term
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Definition
o Most commonly caused by rupture of a small intraparenchymal vessel, which is usually due to hypertension– mostly in putamen
o Also caused by Cerebral amyloid angiopathy – deposition of amyloid in meningeal & cortical blood vessels (same type seen in Alzeimers) causing weaking of vessel walls
o or Charcot-Bouchard microaneurysms |
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Term
| o CADASIL (Cerebral autosomal dominant arteriopathy w/ subcortical infarcts & leukoencephalopahy) |
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Definition
| rare hereditary form of stroke caused by genetic mutations fo the Notch3 receptor (cell signaling protein); microscopically, shows granular osmophilic material |
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Term
| • Subarachnoid Hemorrhage |
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Definition
| most commonly caused by rupture of berry (saccular) aneurysm |
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Term
| o Saccular (berry) Aneurysm |
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Definition
Increased incidence in certain genetic disorders:
• Autosomal dominant polycystic kidney disease
• Ehlers-Danlos syndrome
• Neurofibromatosis type I
• Marfan syndrome
Predisposing factors: hypertension, cigarette smoking |
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Term
| o Saccular (berry) Aneurysm (causing Subarachnoid Hemorrhage) |
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Definition
| Rupture associated with severe headache (“worst headache of my life” thunderclap) |
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Term
| • Arteriovenous malformation |
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Definition
most common clinically significant vascular malformation
o Common located in MCA territory
o Mass of enlarged blood vessels and intervening gliotic tissue
o Usually clinically manifests between 10-30 yrs w/seizure disorder, intracerebral hemorrhage, or subarachnoid hemorrhage
o in newborn can result in congestive heart failure |
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Term
| • Cavernous Malformations |
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Definition
composed of large, irregular vessels with thin collagenous walls
o Often familial, occurring in the cerebellum, pons, and subcortical areas |
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Term
| • Capillary telangiectasias |
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Definition
o Aggregates of dilated, thin-walled vessels, separated by brain parenchyma
o Usually in the pons and are clinically silent |
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