Arteries Of Brain And Spine

Question 1

Causes of spinal cord infarction

Answer 1

Atherosclerosis of spinal arteries or aorta

Dissecting aortic aneurysm

Hypotension

Question 2

Clinical signs of spinal artery infarction

Answer 2

Acute paralysis of 4 limbs (quadriplegia)

No temperature or pain sensation, but preserved vibration am position sense

Radiating back pain

Initially areflexia, later hyperreflexia and spasticity

Question 3

Branches of vertebral artery

Answer 3

Anterior and posterior spinal arteries
PICA
Paramedian branches of superior part of pyramids

Question 4

What is a median medullary syndrome?

Answer 4

Occlusion of the vertebral artery or paramedian branches

Question 5

What is a lateral medullary syndrome?

Answer 5

Occlusion of PICA

Also called: Wallenberg syndrome (dysphagia, dysarthria, dysphonia, facial paresthesia, vertigo, nystagmus, diplopia)

Question 6

Clinical signs of basilar artery occlusion

Answer 6

Changed conscious level or coma

Tetraparesis and tetraplegia

Cranial nerve paresis

Occlusion of the branches: pons syndromes

Question 7

What are the cortical syndromes in a PCA stroke?

Answer 7

Homonomous hemianopsia

Visual hallucinations in blind spot

Occipital infarction of dominant hemisphere: alexia, anopsia, agnosia, memory disorders

Bilateral occipital infarction: anton’s syndrome, balint’s syndrome, cortical blindness

Question 8

Clinical signs of occlusion of anterior cerebral artery

Answer 8

A1 segment: well tolerated, collateral supply

A2 segment:
motor and sensory deficit of contralateral foot
Motor deficit more pronounced in distal Limbs
Head and eyes deviated affected site
Incontinence

Penetrating branches:
Anterior limb of internal capsule and caudate nucleus

Bilateral: paraplegia, incontinence, abulia, aphasia, personality disorders

Question 9

Occlusion of middle cerebral artery

Answer 9

M1: 
Contralateral hemiplegia and hemianesthesia
Homonymous hemianopsia
Eyes deviated to the site of lesion 
Global aphasia
Somnolence 

M2:
Superior trunk: contralateral sensory and motor deficit of face and upper limb and milder lower limb
Eye and head deviated to site of lesion
Mimics M1 occlusion
Global aphasia 

Inferior trunk: aphasia
Homonymous hemianopsia

Question 10

What arteries supply the spinal cord

Answer 10

Spinal artery
Segmental Artery (branches: anterior and posterior radicular arteries)

Question 11

How much is the normal cerebral blood flow?

Answer 11

55ml/100g cerebral tissue/min

Question 12

What are the consequences of a drop in the CBF?

Answer 12

leads to infarction, depending on the duration of ischemic injury

Question 13

most common cause of intercerebral hemorrhage?

Answer 13

hypertension

Question 14

manifestation of anton-babinski syndrome

Answer 14

bilateral occipital dysfunction,
cortical blindness, yet patients refuse to admit
related to anosognosia

Question 15

sensory deficiencies in Wallenberg syndrome and topographic distribution

Answer 15

dysphagia, dysarthria, dysphonia, facial paresthesia, vertigo, nystagmus, diplopia

infarction at lateral part of medulla oblongata
sensory deficits of torso and limbs: contralat.
sensory deficits of face and cranial nerves: ipsilateral

Question 16

perfusion-diffusion mismatch and importance in acute stroke treatment

Answer 16

thrombolytic therapy is indicated if >20% mismatch between core infarct and prenumbra, which means CBF: 10 - 30ml/100g/min

if

Question 17

most common causes of intercerebral hemorrhage

Answer 17

hypertension
stroke
trauma
aneurysm
amyloid angiopathy
tumors

Question 18

sings of subarachnoidan hemorrhage

Answer 18

thundercap headache
vomiting
seizure
confusion
meningism
coma