Term
| VERTIBEROBASILAR SYMPTOMES |
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Definition
| .; drop attacks, vertigo, syncope, diplopia, or other posterior circulation symptoms |
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Term
| NORMAL VERTIBRAL WAVEFORM |
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Definition
Low resistance pattern
Well defined systolic flow
Sustained flow in diastole
Broader bandwidth
Peak systolic velocities range from 20-60 cm/sec
One may be larger than other
Pay attention to reversed flow |
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Term
| SUBCLAVIAN STEAL SYNDROME |
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Definition
| Blood destined for brain through vertebral artery is shunted away, due to high grade stenosis or occlusion of innominate artery or subclavian artery (proximal to take off of vertebral artery) |
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Term
| CLINICAL SIGN FOR SUBCLAVIAN STEAL SYNDROM |
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Definition
BRACHIAL BLOOD PRESSURE DIFFERENCE OF 15-20 MM/HG
PULSES DECREASED ON AFFECTED SIDE
FLOW RESISTANCE IN SUPPLYING VERTEBRAL MAY INCREASE (feeding high resistance bed)
SURGICAL TREATMENT: stent, by-pass graft, endarterectomy |
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Term
| CIRCLE OF WILLIS CONSIST OF: |
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Definition
CONSISTS OF:
Anterior cerebral artery
Middle cerebral artery
Posterior cerebral artery
JOINED BY:
Anterior communicating artery
Posterior communicating artery
SUPPLIED BY:
Internal carotid artery
Basilar artery |
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Term
| CIRCLE OF WILLIS PATHWAY CIRCULATIONS |
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Definition
2 PATHWAYS OF COLLATERAL FLOW
CONTRALATERAL HEMISPHERE
POSTERIOR TO ANTERIOR |
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Term
| CONTRALATERAL HEMESFERE CIRCULATION |
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Definition
AORTA
TO LEFT CCA
TO LEFT ICA
TO LEFT ANTERIOR CEREBRAL ARTERY
TO ANTERIOR COMMUNICATING ARTERY
RIGHT ANTERIOR CEREBRAL ARTERY
TO RIGHT MID CEREBRAL ARTERY |
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Term
| POSTERIOR TO ANTERIOR CIRCULATION |
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Definition
AORTA
TO SUBCLAVIAN ARTERY
TO VERTEBRAL ARTERY
TO BASILAR ARTERY
TO RIGHT POSTERIOR CEREBRAL ARTERY
RIGHT POSTERIOR COMMUNICATING ARTERY
TO DISTAL ICA
TO RIGHT MIDDLE CEREBRAL ARTERY |
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Term
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Definition
| DUPLEX IMAGING OF THE INTRACRANIAL CIRCULATION IS REFERRED TO AS A TRANSCRANIAL DOPPLER EXAM (TCD). |
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Term
| 4 ACOUSTIC WINDOWS FOR TCD |
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Definition
TRANSTEMPORAL APPROACH
TRANSORBITAL APPROACH
TRANSOCCIPITAL APPROACH
SUBMANDIBULAR APPROACH |
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Term
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Definition
Cephalad to zygomatic arch
Anterior and slightly superior to ear
Can visualize the terminal portion of ICA, anterior cerebral, middle cerebral and posterior cerebral artery |
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Term
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Definition
Probe placed on closed eyelid at inner canthus of eye
Power must be reduced
Ophthalmic artery and carotid siphon can be evaluated |
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Term
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Definition
Probe placed between posterior margin of foramen magnum and 1st cervical vertebra
Basilar artery can be evaluated
Intracranial portions of vertebral arteries can be evaluated
Patient should be in prone or sitting position |
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Term
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Definition
Probe placed under the mandible
Petrous portion of ICA can be evaluated |
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Term
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Definition
CAN DETECT INTRACRANIAL STENOSIS OR OCCLUSION
CAN ASSESS COLLATERAL CIRCULATION PATTERNS
CAN EVALUATE VASOCONSTRICTION
CAN EVALUATE INTRACRANIAL ARTERIOVENOUS MALFORMATIONS
CAN EVALUATE SUSPECTED BRAIN DEATH |
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Term
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Definition
ABILITY TO PENETRATE TEMPORAL BONE VARIES BETWEEN PATIENTS
APPROPRIATE ANGLE DIFFICULT TO OBTAIN
RECENT EYE SURGERY IS CONTRAINDICATED FOR TRANSORBITAL APPROACH
HIGHLY OPERATOR DEPENDANT
TECHNICALLY DIFFICULT |
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Term
| TRANSIANT ISCHEMIC ATTACK |
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Definition
A neurologic deficit that reverses within 24 hours (usually in minutes)
Ischemic deficit affects anterior circulation (ICA)
Cause: temporary blood clot in an artery
Risk of stroke increased after TIA
10% in next three months
Increase by 17 times in next 5 years |
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Term
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Definition
SYMPTOMS
Blindness in one eye (amaurosis fugax)
Dysphasia or aphasia (speech)
Contralateral hemiparesis/monoparesis (paralysis)
Behavioral disturbances |
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Term
| RIVERIBLE ISCHEMICK NEUROLOGIC DEFICIT |
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Definition
A neurologic deficit that lasts longer than 24 hours but less than 72 hours
Occurs when blood flow to brain is temporarily restricted
Sudden onset of symptoms |
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Term
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Definition
Transient blindness in one eye
Lasts from seconds to minutes
Similar to shade pulled up or down
Caused by temporary blockage of small blood vessels in eye
Attacks may be occasional or repeated many times per day
Disease is on same side as affected eye |
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Term
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Definition
ABNORMAL LOW RUMBLING SOUND HEARD USING A STETHOSCOPE OVER THE CAROTID ARTERY
CAUSED BY TURBULENT BLOOD FLOW AS IT RUSHES BY AN OBSTRUCTION
MAY INDICATE:
STENOTIC AREA
TORTUOUS VESSEL |
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Term
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Definition
| APHASIA - inability to speak - left hemisphere |
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Term
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Definition
| DYSPHASIA - difficulty in speaking - left hemisphere |
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Term
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Definition
| DYSARTHRIA- slurring and speech distortion due to lack of muscular control - left or right hemisphere |
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Term
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Definition
| HEMIPARESIS - paralysis on one side of body - contralateral hemisphere of brain |
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Term
| VERTEBRO-BASILAR INSUFFICIENCY (VBI)SYMPTOMES |
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Definition
Symptoms usually bilateral
Vertigo (most common)
Ataxia ( muscle coordination)
Weakness in limbs
Drop attacks
Paresthesia
Visual disturbances
Numbness around lips and mouth |
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Term
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Definition
Neurologic effects increase progressively with time
Worsening may occur for up to two weeks |
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Term
| PREDISPOSING RISK FACTORS FOR STROKE: |
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Definition
Age (rare to uncommon less than 60 years)
Hypertension (high pressure damages arterial walls)
Sex (1.5 times more common in males)
Atherosclerosis
Heart disease (atrial fibrillation, damaged valves, recent MI)
Diabetes Mellitus (increased risk of HTN or atherosclerosis)
Obesity
Smoking (irritates endothelial lining) |
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Term
| STROKE RISK FACTORS (MORE) |
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Definition
Hyperlipidemia (increased serum cholesterol)
Polycythemia Vera (increased RBC s)
Use of estrogen (oral contraceptives)
Family History or personal history |
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Term
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Definition
CEREBRAL THROMBOSIS
Blockage by clot within artery of brain
40-50% of strokes
CEREBRAL EMBOLISM
Blockage by embolus swept into brain
30-35% of strokes
HEMORRHAGE
Rupture of blood vessel with bleeding within or over surface of brain
20-25% of strokes |
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Term
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Definition
SEVERE
Loss of consciousness
Coma
Death
Severe mental handicap
Severe physical handicap
MILD
Very few
TYPICAL
Headache
Confusion & dizziness
Visual disturbances
Slurred or loss of speech
Difficulty in swallowing
Hemiplegia (paralysis on 1 side) |
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Term
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Definition
| + A DILATION OF ALL THREE LAYERS OF THE ARTERY. + IT IS VERY RARE FOR AN ANEURYSM TO OCCUR IN THE CAROTID ARTERY. + CAUSES INCLUDE TRAUMA, INFECTION, CONGENITAL WEAKNESS OF THE VESSEL WALL, AND ATHEROSCLEROSIS. |
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Term
| FIBROMUSCULAR DYSPLASIA (FMD) |
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Definition
Dysplasia of the media with overgrowth of collagen
Part of collagen vascular system disorder group
Occurs mainly in women
Has bead like appearance on angiography
Reduced blood supply to the brain |
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Term
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Definition
Carotid body is located next to carotid sinus between ECA and ICA
Carotid body is a small mass of vascular tissue
Functions as chemoreceptor
A tumor on the carotid body is very vascular
Blood supply is via ECA
Treatment is surgical ( may require ligation of ICA or ECA |
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Term
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Definition
Separation of the intima from the media
Separate flow channel within the dissected wall
PROXIMAL DISSECTION
DISTAL ICA DISSECTION
Causes:
Fibromuscular dysplasia
Trauma to neck
Congenital weakness of the media
Chiropractic treatment |
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Term
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Definition
Surgical removal of the intraluminal atherosclerotic material
Surgery not performed with complete occlusion of cervical CCA or ICA
Decision based on extent of disease, severity of disease, patient symptoms, patient’s medical condition |
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Term
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Definition
Provides alternative pathway around stenosis
Rarely performed for ICA disease
May be performed for stenosis in
Proximal CCA
Subclavian artery
Innominate artery |
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