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SF2 - Test 3 > 1 - Vascular Syndromes and Lesions > Flashcards

1 - Vascular Syndromes and Lesions Flashcards

1
Q

What is the major blood supply for internal structures?

What is unique about paramedian penetrating arteries?

What supplies lateral structures?

A

Penetrating Arteries

They “respect the midline”, do not cross over

Short / Long circumferential arteries

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2
Q

Midbrain Vascular Supply

A

Posterior Cerebral Artery (PCA)

top of Basilar Artery (paramedian branches)

Superior Cerebellar Artery (SCA) - tectum

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3
Q

Pons Vascular Supply

A

Basilar Artery (Paramedian, Circumferential)

Anterior Inferior Cerebellar Artery (AICA) - Caudal Pons

Superior Cerebellar Artery (SCA) - Dorsal, Rostral Pons

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4
Q

Rostral Pons Vascular Supply

A

Basilar Artery (paramedian branches, circumferential branches)

Superior Cerebellar Artery (SCA) - Dorsal, Rostral pons

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5
Q

Caudal Pons Vascular Supply

A

Basilar Artery (Paramedian, Circumferential)

Anterior Inferior Cerebellar Artery (AICA) - Caudal Pons

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6
Q

Medulla Vascular Supply

A

Anterior Spinal Artery

Vertebral Artery (paramedian branches)

Posterior Inferior Cerebellar Artery (PICA) - lateral

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7
Q

General features of vertebrobasilar vascular disease?

A

Crossed Signs (decreased sensation on one side of face, contralateral body)

Cranial Nerve abnormalities

Diplopia, Dysconjugate Gaze

Vertigo, Nausea

Ataxia

Dysarthria (speech), Dysphagia (swalling)

Reduced Consciouness

Altered Breathing

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8
Q

Clinical: Vascular Syndromes of Medulla

Lateral Medullary Syndrome (Wallenberg’s Syndrome)

A

Blood: PICA Syndrome - can also involve vertebral artery

Symptoms / Pathway:

1. Ipsilateral Ataxia, Vertigo/nystagmus/nausea / inferior cerebellar peduncle, vestibular nuclei

2. Decreased pain , temperature sensation for ipsilateral face / spinal trigmeinal nucleus and tract; and contralateral body - anterolateral system

3. Ipsilateral Horner’s Syndrome / descending sympathetic fibers

4. Hoarseness/Dysphagia / nucleus ambiguus

5. Ipsilateral Decreased Taste / solitary nucleus

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9
Q

Clinical: Vascular Syndromes of Medulla

Medial Medullary Syndrome

A

Blood: Anterior Spinal Artery, Paramedian Branches of Vertebral Artery

Symptom / Pathway:

1. Contralateral Arm, Leg weakness / corticospinal tract

2. Contralateral loss of fine touch, vibration, conscious proprioception / Medial lemniscus

3. Ipsilateral tongue weakness / Hypoglossal nucleus/nerve

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10
Q

Clinical: Vascular Syndromes of Pons

Dysarthria Hemiparesis (Pure Motor Hemiparesis)

A

Blood: Paramedian Branches of basilar artery

Symptom / Pathway: Contralateral lower face, arm, leg weakness, dysarthria / corticospinal, corticobulbar

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11
Q

Clinical: Vascular Syndromes of Pons

Ataxic Hemiparesis

A

Blood: Paramedian branches of basilar artery

Symptom/Pathway:

1. Contralateral lower face, arm, leg, dysartheria / corticospinal, corticobulbar

2. ***Ataxia / pontine nuclei, pontocerebellar fibers***

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12
Q

Clinical: Vascular Sundromes of Pons

Medial Pontine Basis / Tegmentum

A

Blood Supply: Paramedian branches of basilar artery

Symptoms / Tract:

  1. Contralateral lower face, arm, leg weakness, dysartheria / Corticospinal, Corticobulbar
  2. Ipsilateral Face Weakness / Facial Colliculus
  3. Ipsilateral Horizontal Gaze Palsy / Abducens Nucleus, PPRF
  4. Intranuclear Ophthalmoplegia / MLF
  5. Contralateral loss of fine touch, vivration, conscious proprioception / Medial Lemniscus
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13
Q

Clinical: Vascular Syndromes of Pons

AICA Syndrome (Lateral Caudal Pons)

A

Blood Vessel: AICA

Symptoms / Pathway:

  1. Ipsilateral Ataxia / Middle Cerebellar Peduncle
  2. Vertigo, Nystagmus / Vestibular Nuclei
  3. Decreased Pain, Temperature Sensation for Ipsilateral Face / Spinal Trigeminal Nucleus and Tract
  4. Ipsilateral Horner’s Syndrome / Descending Sympathetic Fibers
  5. Ipsilateral Hearing Loss / Labryinthine Artery (inner ear)
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14
Q

Clinical: Vascular Syndromes of Midbrain

Midbrain Basis (Weber’s Syndrome)

A

Blood Supply: Branches of PCA, top of basilar artery

Symptoms / Pathway:

  1. Ipsilateral Third Nerve Palsy / Oculomotor Nerve Fascicles
  2. Contralateral Hemiparesis / Cerebral Peduncle
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15
Q

Clincial: Vascular Syndromes of Midbrain

Midbrain Tegmentum (Claude’s Sundrome)

A

Blood: Branches of PCA, top of basilar artery

Symptoms / Pathways:

  1. Ipsilateral Third nerve palsy / Oculomotor Nerve Fascicles
  2. Contralateral Ataxia / Red Nucleus, Fibers of Superior Cerebellar Peduncles
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16
Q

Clinical: Vascular Syndromes of Midbrain

Midnrain Basis + Tegmentum (Benedickt’s Syndrome = Claude + Weber)

A

Blood: Branches of PCA, top of Basilar Artery

Symptom / Tract:

  1. Ipsilateral Third Nerve Palsy / Oculomotor Nerve Fasicles
  2. Contralateral Hemiparesis / Cerebral Peduncle
  3. Contralateral Ataxia / Red Nucleus, Fibers of Superior Cerebellar peduncles
17
Q

Clinical: Top-of-the-Basilar Syndrome

A

Blood: Branches of PCA, Top of Basilar Artery

Symptoms / Pathway:

  1. Vision, Memory disturbance / PCA supplies occipital, temporal lobe
  2. Eye movement disorder / Oculomotor Nuclei, Nerve Fasciles
  3. Altered Consciousness / Midbrain reticular formation
  4. Ataxia / entire Cerebellum
18
Q

Clinical: Pontine Hemorrhage

A

Blood: Paramedian branches of basilar artery and junction of tegmentime and base

Can have a wide variety of effexts

19
Q

Clinical: Locked-in Syndrome

A

Area Affected: Vilateral ventral pons (bilateral corticobulbar / corticospinal tracts)

No impairment to consciousness, but unable to move

Vertical eye movement, Sensory pathway usually spared,

20
Q

Clinical: Dorsal Midbrain (Parinaud’s) Syndrome

A

Causes: Stroke, Compression of dorsal midrain, pretectal area (pineal tumor, hydrocephalus)

Symptoms / Pathways:

  1. Impairment of Vertical Gaze (upward) / Vertical Gaze Center

2, Large, Irregular blown pupils / Damage to Edinger-Westphal nucleus

  1. Eyelid Abnormalities (retraction, ptosis) / Oculomotor Nuclei
  2. Impaired Convergence / Vergence control center
21
Q
A

SF2 - Test 3 (25 decks)

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