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Assignment questions
NursingCase studyPathophysiology

Fred's headache: brain function and circulation

The two vessels in the CT report belong to different circulations — one supplies the brain, the other supplies the dura — and question b exists to see whether you notice.

Editorial process

Last reviewed · August 15, 2026

01

Two questions, one about concepts and one about circulation

Read Fred's findings as a set before answering either question. Two weeks of headache that has worsened sharply over two days, with photophobia, nuchal rigidity and projectile vomiting, is meningeal irritation with raised intracranial pressure — the vomiting is projectile because it is centrally driven rather than gastric, and the neck stiffness reflects blood or inflammation irritating the meninges. That is what question a is asking you to connect: the concept of a disorder of brain function is that the deficit follows from what the affected structure does and from the pressure the cranium cannot accommodate, rather than from the lesion's size. A small bleed in a rigid box produces symptoms out of proportion to its volume, which is the Monro-Kellie principle and is worth naming. Fred's two-week history followed by rapid deterioration fits that: the compartment compensated until it could not, and then decompensated quickly.

Question b is about cerebral circulation specifically, and the case has given you two vessels from two different systems. The basilar artery is part of the posterior circulation supplying the brainstem, cerebellum and posterior cerebrum, and an arteriovenous malformation there is a direct artery-to-vein connection with no intervening capillary bed — so flow is high, pressure is transmitted to thin-walled veins, and rupture risk follows. Note the consequence of location: brainstem involvement threatens respiratory and cardiovascular centres, which is why posterior lesions are more dangerous than their size suggests. The middle meningeal artery is not a cerebral vessel at all — it is a branch of the maxillary artery supplying the dura, and it is the classic source of an extradural haematoma. Say that the two lesions sit in different compartments, then bring in the circulation concepts: the circle of Willis and its collateral capacity, autoregulation and its range, and why perfusion falls as intracranial pressure rises.

Likely learning objectives

Inferred from the brief — check these against your own rubric.

  • 01
    Connect presenting symptoms to raised intracranial pressure and meningeal irritation.
  • 02
    Explain why lesion size predicts symptoms poorly inside a rigid cranium.
  • 03
    Describe an arteriovenous malformation's haemodynamics and why location matters.
  • 04
    Distinguish the cerebral circulation from the meningeal supply.
Assignment instructionsQuoted verbatim

Read the full question

Review every instruction before using the planning guidance that follows.

Fifty-four–year-old Fred is complaining of a headache that started about 2 weeks ago. For the past 2 days, the headache has increased in severity, and he is photophobic and has uncial rigidity and projectile vomiting. CT scan results show an arteriovenous malformation in the basal artery and a small hemorrhagic bleed in the middle meningeal artery. a. How is the concept “disorders of brain function” related to Fred’s presenting symptoms? b. What aspects of cerebral circulation would come into play in Fred’s case?
Course-wide instructions that accompany this question

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes. Disorders Of The Brain Essay Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages. Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor. The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument. ADDITIONAL INSTRUCTIONS FOR THE CLASS Discussion Questions (DQ) Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses. Weekly Participation Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. APA Format and Writing Quality Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition. Use of Direct Quotes I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. LopesWrite Policy For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score. Late Policy The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. Communication Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours. Disorders Of The Brain Essay

02

Turn the brief into deliverables

  1. 01
    An account linking each symptom to a mechanism.
  2. 02
    An explanation of the disorders-of-brain-function concept applied to Fred.
  3. 03
    The haemodynamics of an arteriovenous malformation and the significance of its location.
  4. 04
    The circle of Willis, autoregulation and perfusion pressure applied to the case.
  5. 05
    APA-formatted scholarly citations.
03

The findings, the concept, then the vessels

01

Read the findings as a set

Assemble headache, photophobia, nuchal rigidity and projectile vomiting into one picture.

02

Disorders of brain function as a concept

Explain deficits as a function of structure affected and pressure, not lesion size.

03

The arteriovenous malformation

Describe the direct shunt, the high flow and the rupture risk.

04

Posterior circulation and location

Explain what the basilar artery supplies and why that raises the stakes.

05

The meningeal vessel and circulation concepts

Distinguish the dural supply, then apply circle of Willis, autoregulation and perfusion pressure.

04

Sources on AVM and cerebral circulation

Recommended databases

  • NCBI Bookshelf (StatPearls)
  • PubMed Central
  • Your pathophysiology text on neurological disorders
  • An anatomy atlas for the vascular territories

Search sequence

  1. 1.
    Confirm the anatomy of both named vessels before writing, since the compartment distinction is the point.
  2. 2.
    Read on intracranial arteriovenous malformation haemodynamics rather than on aneurysm, which is a different lesion.
  3. 3.
    Look up cerebral autoregulation limits so the perfusion argument is quantitative rather than vague.
  4. 4.
    Check the presentation of raised intracranial pressure so each symptom can be attributed.
05

Reference shortlist

These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.

Nothing here is cleared for citation until you have read it.

  1. 01

    Intracranial Arteriovenous Malformations

    StatPearls, NCBI Bookshelf · 2023

    Arteriovenous malformation haemodynamics, rupture risk and the significance of location.

  2. 02

    Subarachnoid Hemorrhage

    StatPearls, NCBI Bookshelf · 2023

    Meningeal irritation, raised intracranial pressure and the presentation Fred shows.

  3. 03

    Concussion

    StatPearls, NCBI Bookshelf · 2023

    The neurometabolic consequences of intracranial injury, useful for the disorders-of-function concept.

  4. 04

    Glasgow Coma Scale

    StatPearls, NCBI Bookshelf · 2023

    Neurological assessment, relevant to how deterioration would be detected in Fred.

06

Review before submission

Common mistakes

  • Treating the middle meningeal artery as part of the cerebral circulation.
  • Explaining the symptoms by lesion size rather than by pressure.
  • Describing an arteriovenous malformation without the absent capillary bed, which is the whole mechanism.
  • Omitting the significance of the posterior circulation location.
  • Listing circulation facts without applying them to Fred.

Submission checklist

  • Is each symptom tied to a mechanism rather than named?
  • Have you invoked the fixed-volume principle?
  • Is the arteriovenous shunt explained as a missing capillary bed?
  • Have you separated the two vessels into their proper compartments?
  • Are autoregulation and perfusion pressure applied to this patient?

Use this guide to plan and review your own work. Follow your institution's rules and read our academic-integrity policy.

Written by

Aaron Bishop

MA, Education

assignment interpretation and research-methods coaching across disciplines

Aaron leads the EssayCrackers editorial desk. He works on how assignment briefs are read — what a rubric is actually asking for, and where students most often answer a different question than the one set.

Reviewed by

Dr. Nathan Cole

PhD, Rhetoric & Composition

Argumentation and thesis development

Nathan teaches first-year composition and directs a university writing center. He reviews EssayCrackers guides for argumentative soundness and citation accuracy.

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