What is ICP?
A measurement of the pressure of brain tissue and the cerebrospinal fluid that surrounds the brain and spinal cord
What is Monro-Kellie hypothesis?
Intracranial volume is fixed due to non-compliant skull
Change in volume of non- compressible contents or addition of a space occupying lesion (SPOL) increases pressure
What is the pathology of raised ICP?
Reduced blood flow -> ischaemia
Reduced energy production
Pump failure on cell membrane
Cellular dysfunction
Interstitial microenvironment changes (toxic metabolites)
Membrane damage and cell death
What is MAP?
Mean arterial pressure
Difference between systolic and diastolic
What is CPP?
Central perfusion pressure
Difference between MAP and ICP
What is CVR?
Cerebro Vascular Resistance
Resistance offered by cerebral vasculature to flowing blood
What is autoregulation?
Ability of brain to maintain constant blood flow over wide range of pressures
What does cerebral blood flow depend on?
MAP
ICP
Vascular resistance
Autoregulation
What is stroke?
Sudden onset of focal or global neurological symptoms caused by ischaemia or haemorrhage and lasting more than 24 hours
What % of strokes are ischaemic?
85%
What % of strokes are haemorrhagic?
15%
What are the causes of an ischaemic stroke?
- Large artery atherosclerosis
- Cardioembolic
- Small artery occlusion
- Undetermined/Cryptogenic
- Rare causes
- Arterial dissection
- Venous sinus thrombosis
What are the causes of a haemorrhagic stroke?
- Primary intracerebral haemorrhage
- Secondary haemorrhage
- Subarachnoid haemorrhage
- Arteriovenous malformation
What are some modifiable risk factors for stroke?
Hypertension
Smoking
Drugs
Diet
Exercise
Diabetes
Alcohol
Obesity
High lipid intake
Atrial fibrillation
What are some non-modifiable risk factors for stroke?
Previous stroke
Age
Male
FH
Hypercoagulable states- malignancy, genetics
What are the frontal lobe functions?
- High level cognitive functions
- Memory
- Voluntary eye movement
- Motor control of speech- Broca’s area
- Motor cortex
- Urinary continence
- Emotion and personality
What are the parietal lobe functions?
- Sensory cortex
- Sensation
- Awareness
- Spatial orientation and visuospatial information- non dominant right hemisphere
- Performing learned motor tasks- dominant left hemisphere
What are the temporal lobe functions?
- Primary auditory
- Comprehension of speech- Wernicke’s
- Visual, auditory and olfactory perception
- Learning, memory and emotional affect
What are the occipital lobe functions?
- Primary visual cortex
- Visual perception
- Involuntary smooth eye movement
What are the cerebellar functions?
Maintaining balance
Coordinating movement
Motor learning
What are the signs of cerebellar damage?
Vertigo
Ataxia
Nystagmus
Intentional tremor
Slurred speech
Hypotonia
Exaggerated broad based gait
Dysdiadochokinesia
VANISHED
What does blockage of the anterior cerebral artery cause?
Leg> arm weakness
What does blockage of middle cerebral artery cause?
Face and arm> leg weakness
What is the clinical presentation of stroke?
Motor- clumsy/weak limb
Sensory- loss of feelings
Speech- dysarthria/dysphasia
Neglect/visuospatial problems
Vision- loss in one eye, hemianopia
Gaze palsy
Ataxia/vertigo/incoordination/nystagmus
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Anatomy Workbooks30
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CNS Anatomy143
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Embryology17
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CNS Physiology114
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Sensory Physiology33
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Degenerative diseases22
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Multiple Sclerosis20
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Epilepsy25
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Headache54
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Stroke39
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Head injury29
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Coma23
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Brain tumours19
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Spinal disorders49
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Hydrocephalus23
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Muscle and nerve disease21
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Infections30
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Neuroradiology5
