Vascular Disease of the Spinal Cord Blood Supply Origin: vertebral, subclavian, iliac arteries, aorta. Branches form single anterior median spinal artery, two posterior spinal arteries. Thoracic region: blood supply relatively…
Cerebral Veins and Sinuses Occlusion of cerebral veins and sinuses associated with various disorders (Table 47.1). Lateral, cavernous, superior sagittal sinuses most frequently affected. Lateral Sinus Thrombosis Usually due to…
Subarachnoid Hemorrhage Acute hemorrhage into space between pia and arachnoid membranes (subarachnoid space). 5% of all strokes; nearly 30,000 cases annually in the United States (annual incidence 1/10,000). 80% due…
Treatment and Prevention of Stroke Atherothrombotic Strokes and Tias Surgery Indications for carotid endarterectomy (CEA): Stenosis ≥70% (if patient medically suitable). Balloon angioplasty, stents (extracranial and intracranial stenosis): under investigation….
Stroke in Children Important differences from adults characterize childhood stroke: 1) predisposing factors (e.g., cyanotic heart disease) common; 2) clinical evolution (outcome often better in children); 3) anatomic site of…
Differential Diagnosis of Stroke Clinical Features of Stroke Subtypes Distinction essential in choice of acute treatment of stroke: in first 3 hours, thrombolysis may be indicated in acute infarct; contraindicated…
Other Cerebrovascular Syndromes Lacunar Strokes Small ischemic infarcts due to occlusion of small penetrating arterioles, usually with sustained hypertension. Location: distribution of deep penetrating arteries (basal ganglia, deep hemispheric white…
Genetics of Stroke Ischemic Stroke Role of genetics incompletely understood in pathogenesis of ischemic stroke; confounded by possible environmental factors. Documented risk factors of ischemic stroke with strong genetic influence:…
Cerebral and Cerebellar Hemorrhage Intracerebral Hemorrhage Blood in brain parenchyma. Etiology Arteriopathy of deep penetrating arteries (arteriolosclerosis): basal ganglia, thalamus, brainstem, cerebellum. Most common type of intracerebral hemorrhage. Greatest risk…
Cerebral Infarction Specific Vessel Occlusions See Table 39.1. Following are notes on selected features. Middle Cerebral Artery (MCA) Unusual Signs of Dominant Hemisphere Damage Apraxia: see Chapter 2. Gerstmann syndrome:…
