Vascular disorders
(PEARLS) (Smarty PANCE)
100% VERIFIED ANSWERS
2024/2025
What is an arteriovenous malformation?
Arteriovenous malformation is when a group of arteries directly link up with a
group of veins instead of through capillaries.
What is the most common manifestation of brain arteriovenous malformations?
The most common manifestation of brain arteriovenous malformations is intracranial
hemorrhage. AVNs are the second most common cause of subarachnoid
hemorrhage in the brain
What are the most common arteries affected by the arteriovenous
malformations?
The posterior branches of the middle cerebral artery are the most common arteries
affected by the arteriovenous malformations.
What is Osler-Weber-Rendu syndrome?
Osler-Weber-Rendu syndrome is an autosomal dominant vascular disorder that
presents with arteriovenous malformations and other blood vessel
problems throughout the body. Also known as Hereditary hemorrhagic telangiectasia
syndrome.

How does CT scan compare to MRI in detecting central nervous system
arteriovenous malformations?
CT scan is less sensitive than MRI in detecting central nervous system arteriovenous
malformations
What is the grading system used for preoperative risk-stratification of brain
arteriovenous malformations?
The Spetzler-Martin grading system is used for preoperative risk-stratification of brain
arteriovenous malformations
What is used for the treatment of patients with brain arteriovenous malformations
who are not surgical candidates?
Radiotherapy is used for the treatment of patients with brain arteriovenous
malformations who are not surgical candidates
What can happen as a result of the heart having to work harder in people with
arteriovenous malformations?
Because the heart has to work harder in people with arteriovenous malformations, this
can lead to high-output heart failure
What is the gold standard for the diagnosis of brain arteriovenous
malformations?
Cerebral angiography is the gold standard for the diagnosis of brain arteriovenous
malformations
What is a cerebral aneurysm?
A cerebral aneurysm or an intracranial aneurysm, is a weak bulging spot on the wall of
a brain artery very much like a thin balloon or weak spot on an inner tube.
How are cerebral aneurysms classified?

Cerebral aneurysms are classified both by size and shape
● Small aneurysms have a diameter of less than 15 mm
● Larger aneurysms include those classified as large (15 to 25 mm)
● Giant (25 to 50 mm), and supergiant (over 50 mm)
A small sac-like aneurysm of a cerebral artery. Most often found in the circle of
Willis in the brain circulation
Consists of a small, spherical vessel dilation
Saccular ("berry") aneurysm
Circumferential enlargement of a vessel with tapering at both ends
Fusiform aneurysm
Weakening of the arterial wall caused by a closed head injury or penetrating
trauma to the brain.
Traumatic aneurysm
A dilation of an artery due to damage of the vessel wall by an infection which can
be bacterial, fungal, or viral in origin;
Mycotic aneurysm
Accounts for approximately 75% of nontraumatic cases of subarachnoid
hemorrhage (SAH) and has a mortality rate of 50%.
Ruptured saccular (berry) aneurysm
Classic SAH Presentation?
The classic SAH presents as sudden onset of an unusually severe, generalized
headache, which patients may describe as "the worst headache I've had in my life." The
headache may be accompanied by nausea and vomiting, seizure activity, or an altered
state of consciousness.

What is the gold standard for the diagnosis of cerebral aneurysm?
Cerebral angiography (Gold Standard) should be done to evaluate the entire
vasculature when convenient because as many as 20% of individuals will have multiple
aneurysms.
The gold standard for diagnosis is cerebral angiography. We don't typically start with
angiography, we will start with imaging such as CT or MRA because it is less sensitive
but easier to perform. But if the question asks you what is the Gold Standard for
cerebral aneurysm the answer is angiography
Two treatment options for securing intracranial aneurysms?
Two treatment options for securing intracranial aneurysms
● Surgical clipping (watch video)
● Endovascular coiling (watch video)
What is a stroke?
Damage to the brain from interruption of its blood supply
What are the 2 most basic types of strokes?
Ischemic strokes (approximately 80%) and Intracranial hemorrhages (approximately
20%). Bleeding into an area of primary ischemic stroke is called "hemorrhagic
conversion."
What is an intracranial hemorrhage (ICH)?
An intracranial hemorrhage (ICH) is a type of stroke, called a hemorrhagic stroke, or
"brain attack." Its name refers to the bleeding (hemorrhaging) within the brain or skull
caused by a blood vessel that ruptures and creates a pool of blood called a hematoma.
4 types of intracranial hemorrhages?

1. Epidural
2. Subdural
3. Subarachnoid
4. Intracerebral
Extra-axial Hemorrhage (hemorrhages that occur outside the brain tissue)
1. Epidural
2. Subdural
3. Subarachnoid
Intra-Axial Hemorrhage (hemorrhages that occur inside the brain tissue)
4. Intracerebral hemorrhage
5. Intraventricular hemorrhage
Elderly patient with a history of multiple falls who is now presenting with
neurological symptom
Subdural hematoma
What is a subdural hematoma?
Blood collection under the dura matter and above arachnoid matter
What causes a subdural hematoma?
Tearing of "bridging" veins that pass through the space between the cortical surface
and the Dural venous sinuses or injury to the brain surface with resultant bleeding from
cortical vessels
What classic findings appear on head CT scan for a subdural hematoma?

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2024-2025 Vascular Disorders (PEARLS) (Smarty PANCE) with Answers (106 Solved Questions)

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