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Ischemia of the brain

Terms in this set (35)

Arteritis: small and large vessel inflammation was once commonly seen in syphilis and TB but now seen mostly in the immunosuppressed
1. PAN (polyartitis nodosa) and collagen vascular diseases can involve cerebral vessels causing single or multiple infarcts
2. Primary angiitis of the CNS: involves small to medium sized parenchymal and subarachnoid vessels with infiltration by chronic inflammatory cells and giant cells (relatively distinct feature). Limited to the CNS. Involves giant cells, a relatively distinct feature. Not to be confused with giant cell arteritis which is a different entity

Most due to localized arteriolar disease but some are associated with systemic disorders
1. Hypercoagulable states: PCV (Polycythemia vera), sickle cell, malignancies
2. Dissecting aneurysm of extracranial arteries especially those in the neck
3. Drug abuse: particularly stimulants such as methamphetamine and cocaine, but heroin has been implicated as well. Sympathomimetics (drugs stimulating sympathetic nervous system) can lead to focal ischemia. Cocaine is also a vasoconstrictor, contributing to injury. Even non-stimulates such as heroine has been implicated in focal ischemia.

CADASIL
Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy. Associated with mutations in the Notch3. Characterized by recurrent strokes and dementia. Ischemic damage results as strokes accumulate over time. Abnormalities of white matter and concentric narrowing of the adventitia and media of leptomeningeal arteries. Rare hereditary form of stroke