4. CVD

• Magnetic Resonance Angiogram is a non-invasive diagnostic test that shows the actual blood vessels in the neck and brain and can help detect blockage and aneurysm.
• Cerebrovascular disease includes all disorders in which an area of the brain is temporarily or permanently affected by ischemia or bleeding and one or more of the cerebral blood vessels are involved in the pathological process.
• Cerebrovascular disease includes stroke, carotid stenosis, vertebral stenosis and intracranial stenosis, aneurysms, and vascular malformations.
• Restrictions in blood flow may occur from vessel narrowing (stenosis), clot formation(thrombosis), blockage(embolism) or blood vessel rupture(hemorrhage) lack of sufficient blood flow (ischemia) affects brain tissue.
• Cerebral circulation refers to the movement of blood through the network of blood vessels supplying the brain.
• The arteries deliver oxygenated blood,glucose, and other nutrients to the brain and the veins carry deoxygenated blood back to the heart, removing carbon dioxide, lactic acid and other metabolic products.
• The circle of willis, a circulatory anastomosis that supplies blood to the brain and surrounding structures while providing redundancy in case of any interruption, is a key protection; failure of these safe guards results in cerebrovascular accidents, commonly known as strokes.
• Cerebral blood flow refers to the amount of blood that the cerebral circulation carries.
• In adults, Cerebral Blood Flow is typically 750 millimeters per minute or 15% of the cardiac output; tightly regulated to meet the brain’s metabolic demands.
• Too much blood can raise intracranial pressure (normal range: 5-15mmhg) which can compress and damage delicate brain tissue.
• Too little blood flow (ischemia) results in tissue death.
• Ischemic cascade is a biochemical cascade triggered when the tissue becomes ischemic, potentially resulting in damage to and death of brain cells.
• The time when brain last without oxygen beyond 3 minutes ischemia will activate the ischemic cascade.
• Cerebral angiography, also known as vertebral angiogram or carotid angiogram, is a procedure where a catheter is inserted into the arteries of the neck and x-ray pictures are taken after injecting contrast dye.
• Magnetic Resonance Angiogram (MRA) is a noninvasive study which is conducted in a magnetic resonance imager (MRI).
• The ultrasound is turned on and images of the carotid arteries and pulse wave forms are obtained.
• Mri of the brain can help determine whether there are signs of prior mini-strokes.
• An electroencephalogram (EEG) is a diagnostic test using small metal discs (electrodes) placed on a person’s scalp to pick up electrical impulses.
• Carotid duplex (carotid ultrasound) is a procedure that uses ultrasound to help detect plaque, blood clots or other problems with blood flow in the carotid arteries.
• Contrast dye allergy can lead to an allergic reaction to iodine, found in seafoods and iodine salt.
• In Carotid Duplex diagnostic test, the gel is applied to help transmit the sound to the skin surface.
• Both the superficial and deep venous systems are evaluated in a doppler ultrasound.
• Doppler ultrasound involves placing a water-soluble gel on the transducer and the skin over the veins of the extremity being tested.
• A water-soluble gel is placed on the skin where the transducer (a hand held device that directs the high frequency sound waves to the arteries being tested) is to be placed.
• Magnetic resonance imaging (MRI) produces three-dimensional images of body structures using magnetic fields and computer technology.
• Bone, blood and brain tissue have very different densities and can easily be distinguished on a ct scan.
• There is a swishing sound on the Doppler if the venous system is normal.
• Lumbar puncture (spinal tap) is an invasive diagnostic test that uses a needle to remove a sample of csf from the space surrounding the spinal cord helpful in detecting bleeding caused by a cerebral hemorrhage.
• Computed tomography (CT or CAT scan) is a diagnostic image created after a computer reads x-rays.
• A ct scan is a useful diagnostic test for hemorrhagic strokes because blood can easily be seen; however damage from an ischemic stroke may not be revealed on a ct scan for several hours or days and the individual arteries in the brain cannot be seen.
• In Magnetic Resonance Angiogram (MRA), magnetic images are assembled by a computer to provide an image of the arteries in the head and neck.
• Carotid duplex has no known risks and the test is noninvasive and painless.
• Avocado allergic individuals may also be allergic to latex.
• Cerebral circulation refers to the movement of blood through the network of blood vessels supplying the brain.
• The Circle of Willis, a circulatory anastomosis that supplies blood to the brain and surrounding structures while providing redundancy in case of any interruption, is a key protection; failure of these safe guards results in cerebrovascular accidents, commonly known as strokes.
• • Cerebral blood flow refers to the amount of blood that the cerebral circulation carries.
• • In adult, CBF is typically 750 millimeters per minute or 15% of the cardiac output; tightly regulated to meet the brain’s metabolic demands.
• • Too much blood can raise intracranial pressure (normal range: 5-15mmhg) which can compress and damage delicate brain tissue.
• Ischemic cascade is a biochemical cascade triggered when the tissue becomes ischemic, potentially resulting in damage to and death of brain cells.
• CEREBRAL ANGIOGRAPHY (Vertebral angiogram, carotid angiogram)- this procedure is monitored by a fluoroscope (a special x ray that projects the images on a tv monitor)