Chapter 19: Testing Considerations, Patient History, Mechanisms of Disease, and Physical Examination.

Dizziness (definition)

A sensation of whirling within one's head, lightheadedness, and a tendency to fall.

Syncope (definition)

A transient loss of consciousness.

____: Type of stroke. Symptoms of sudden onset; considered unstable.

Acute

_________ is a common pathologic condition in which the arteries thicken, harden, and lose their elasticity, creating narrowing (stenosis) that can reduce distal blood flow and adversely affect brain perfusion.

Atherosclerosis

Homonymous hemianopia (definition)

Blindness in the corresponding, right and left, visual fields.

____ ____: Type of stroke. No progression or resolution of the symptoms; considered stable.

Completed stroke

______ _____, the most common form of diabetes, is a chronic systemic disease characterized by disorders of the metabolism of insulin, carbohydrate, fat, and protein. The chronic complications are primarily vascular.

Diabetes mellitus

Vertigo (definition)

Difficulty in maintaining equailibrium: a sensation of either moving around in space or having objects move around one.

Diplopia (definition)

Double vision.

Drop Attack (definition)

Falling to the ground without other symptoms or loss of consciousness.

______ _________ is most commonly caused by dysplasia of the media along with over-growth of collagen. Dysplasia of the media occurs in the mid to distal segments of vessels, unlike atherosclerosis, which usually develops at the origins of vessels. ____ has a characteristic bead-like appearance on angiography. It is seen most often in younger women.

Fibromuscular dysplasia ; FMD

_______, the second most common mechanism of cerebrovascular insufficiency, may be the result of: Hypertension Ruptured aneurysm Trauma

Hemorrhage

______ plaque is a bright plaque in a vessel of the retina. Detected by an ophthalmologist, ____ plaques are actually atheromatous emboli that contain cholesterol crystals and may have originated from plaque either in the carotid artery or more proximal vessels.

Hollenhorst ; hollenhorst

__________: Because lipids are insoluble in water, an excessive amount of plasma lipids is closely associated with the development of atherosclerosis.

Hyperlipidemia

________ may be a causative factor in the development of atherosclerosis, or it may enhance the development of the atherosclerotic process. It almost certainly helps to precipitate clinical events associated with atherosclerosis, e.g., embolization and aneurysms.

Hypertension

_____ ______ is evident on duplex scans as a sonolucent area within plaque. This finding is also important as this plaque may be at higher risk for rupture, resulting in distal embolization.

Intraplaque hemorrhage

Anesthesia (definition

Loss of sensation.

Ataxia (definition)

Muscular incoordination.

_______ ______: Intimal thickening results from hyperplasia of smooth muscle cells. Hyperplasia is a response to vascular injury, which may be the result of vascular reconstruction, e.g., carotid endarterectomy. Denuding the endothelium surgically leads platelet accumulation, endothelial regeneration, and proliferation of smooth muscle cells. A hemodynamically significant stenosis may develop within 6-24 month following endarterectomy.

Neointimal hyperplasia

Normally posterior or anterior vessels supply blood to the brain stem, cerebellum, and occipital lobes of the brain?

Posterior

_____ _____ _____ _____ usually lasts longer than a TIA, but the deficit it creates takes slightly longer than 24 hours to resolve. That is, brain tissue is damage but recovers completely.

Reversible ischemic neurologic deficit (RIND)

____ __ ___: Type of stroke. Symptoms come and go; considered unstable.

Stroke in evolution

Aphasia (definition)

The inability to speak

Bilateral parethesia (definition)

The sensation of prickling or tingling of the skin.

Unilateral parestheisa or anesthesia (definition)

Tingling, numbness, or lack of feeling on one side of the body.

___ ___ ___ is a fleeting neurologic dysfunction without lasting effects. Symptoms usually last from a few minutes to a few hours, but never more than 24 hours. Depending on the cerebral territory involved, symptoms may include sensory and/or motor dysfunction of an arm or leg, speech impairment, and/or monocular visual disturbances. The etiology of this is usually embolic, and the heart or carotid artery is most often the source of emboli.

Transient ischemic attack (TIA)

_______ _______ usually causes fleeting symptoms (often lasting only seconds or minutes), e.g., bilateral visual blurring or paresthesia and complaints of vertigo, ataxia, and drop attacks.

Vertebrobasilar insufficiency

Unilateral paresis (definition)

Weakness or slight paralysis on one side of the body.

A ______ _____, or _____, produces a permanent neurologic deficit.

cerebrovascular accident (CVA) ; stroke

Studies have demonstrated that the chemicals in ____ irritate the endothelial lining of the arteries (which contributes to inflammation and therefore plaque buildup) in addition to causing vasoconstriction.

cigarettes

A _____ lesion is a fibrous plaque that contains fibrous tissue, more collagen, calcium, and cellular debris.

complicated

A ___ ___ is a thin layer of hypoechoic lipid material on the intimal layer of the artery. (Referring to plaque)

fatty streak

A ____ plaque is an accumulation of lipids that is covered by more lipid material, collagen, and elastic fiber deposits.

fibrous

Dysphasia (definition)

impaired speech

The two most common mechanisms of cerebrovascular insufficiency are ____ and ____.

ischemia ; hemorrhage

A lesion in the opposite or same side as the dominate hand might cause aphasia or dyspashia?

opposite

A left hemisphere stroke results in neurologic deficits to the ____ side of the body.

right

Amarousis fugax (definition)

temporary partial or total blindness, usually of only one eye.

An _______ lesion is characterized by the deterioration of the normally smooth surface of the fibrous cap. _____ lesions are of a particular importance because they may shed multiple small pieces of debris that embolize distally.

ulcerative ; Ulcerative