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:…
Transient Ischemic Attack Definition TIA: neurologic symptoms of ischemic origin that last less than 24 hours; most 1 to 60 minutes. Postulated Mechanisms Transient occlusion: intermittent occlusion by fragment of…
Examination of the Patient with Cerebrovascular Disease Goals Immediate information about size, location, etiology of stroke, to guide acute treatment. Establish site and number of suspected lesions, which may not…
Pathogenesis, Classification, and Epidemiology of Cerebrovascular Disease Definition and Nosology Stroke: sudden loss of neurologic function (global or focal) due to vascular disruption (infarction or hemorrhage) in CNS. Transient Ischemic…
Whipple Disease Caused by bacilliform bacterium, Tropheryma whippelii (Actinomycetaceae family). Involves intestinal tract, heart, lungs, liver, kidneys, brain. Rare. Systemic manifestations: weight loss, abdominal pain, diarrhea, arthritis. Anemia, hypoalbuminemia, steatorrhea….
Prion Diseases Human prion diseases: kuru, Creutzfeldt-Jakob disease (CJD), variant CJD, Gerstmann-Sträussler-Scheinker syndrome (GSS), familial fatal insomnia (FFI). All progressive, fatal. May be sporadic, infectious, or inherited. Human prion protein…
Reye Syndrome Childhood encephalopathy with fatty changes in viscera. Rarely affects infants or adults. Epidemiology: linked to ingestion of aspirin-containing compounds to treat childhood fever. Usually associated with influenza A,…
Bacterial Toxins Diphtheria Diphtheria exotoxin binds to receptors on peripheral nerves, inhibits protein synthesis. Demyelinating neuropathy more likely with severe infection. Palatal and pharyngo-laryngo-esophageal paralysis early; prominent signs in pharyngeal…
