cns3 - darkhorse

[ArchivalUser]

A 73-year-old man is undergoing a radical prostatectomy for prostatic adenocarcinoma. During this procedure the anesthesiologist reports a drop in blood pressure with hypotension that persists for 30 minutes despite intervention with pressor agents. Which of the following pathologic lesions is most likely to occur in his brain as a consequence of this prolonged hypotensive episode?

A Hydranencephaly

B Linear parasaggital infarction

C Lacunar infarcts of basal ganglia

D Parietal lobe hemorrhagic infarct

E Anterior pituitary necrosis

[ArchivalUser]

bbb?

[ArchivalUser]

anterior pituitary necrosis -sheehan or what ?
i wa sthinking lacunar, but no...i will go with eeeeeeee

[ArchivalUser]

B??

[ArchivalUser]

A) Incorrect. This is a consequence of ischemia-infarction in utero with loss of much cerebral cortex.
(B) CORRECT. The most sensitive areas of the brain to ischemia will be the 'watershed' areas between anterior and middle cerebral arterial circulations.
C) Incorrect. Lacunar infarcts are typically a consequence of hypertensive cerebrovascular disease.
D) Incorrect. Hemorrhagic infarcts, particularly in the distribution of the middle cerebral artery, suggest an embolic etiology.
E) Incorrect. Sheehan syndrome is more typically postpartum, as the pituitary is enlarged in pregnancy.