Blood Supply Injuries Flashcards
what is quadriplegia/paresis?
all 4 extremities are paralyzed or weak
what is hemiplegia/paresis?
upper and lower extremities on 1 side are paralyzed or weak (1/2 body affected)
what is paraplegia/paresis?
both upper OR lower extremities are paralyzed or weak
what is monoplegia/paresis?
one extremity is paralyzed or weak
what is an internal carotid infarction?
the internal carotid arteries may become atherosclerotic and eventually occluded
the extent of an internal carotid infarction may include the territories of the…
anterior and middle cerebral arteries
the ophthalmic artery is one of the first branches of the ____
internal carotid artery
occlusion of the ophthalmic artery causes…
unilateral visual symptoms such as dimming, colour changes, or scotomas
anterior cerebral infarction causes symptoms of injury to the…
medial cerebral hemisphere
symptoms of anterior cerebral infarction
- contra spastic paralysis & sensory loss of mainly distal leg & perinium (incontinence) [paracentral lobule]
- mental confusion, impaired judgement, flat affect [prefrontal lobe]
- abulia [bilateral prefrontal lobe]
what is abulia?
behavioural disturbance characterized by apathy & muteness
anterior choroidal infarction causes symptoms of injury to the…
posterior limb of internal capsule and optic tract/LGB
symptoms of anterior choroidal infarction
- contra spastic paralysis & sensory loss of body & face [internal capsule]
- contra homonymous hemianopsia [LGB]
middle cerebral infarction causes symptoms of injury to the…
lateral cerebral cortex
symptoms of middle cerebral infarction
- contra spastic paralysis & sensory loss of face & upper extremity [precentral & postcentral gyrus]
- contra homonymous hemianopsia [optic radiation]
- acute (1-2days) paresis of contra conjugate gaze [frontal eye field]
- aphasia [Broca’s, Wernicke’s, global] if dominant side affected
- astereognosis/neglect [right parietal lobe]
- apraxia [premotor cortex]
- Gerstmann’s syndrome
injury to left angular gyrus causes symptoms of ____
Gerstmann’s syndrome
what is Gerstmann’s syndrome?
- agraphia
- acalculia
- inability to distinguish L from R
- finger agnosia
symptoms of distal occlusion of posterior cerebral artery affecting the striate cortex
contra homonymous hemianopsia
symptoms of distal occlusion of posterior cerebral artery affecting splenium
alexia (unable to read) without agraphia (unable to write)
symptoms of proximal bilateral occlusion of posterior cerebral artery affecting basilar junction including both visual cortices
Anton’s syndrome (failure of blind patient to recognize inability to see)
symptoms of proximal occlusion of posterior cerebral artery
- contra sensory loss or thalamic syndrome [thalamus]
- hemiballism [subthalamic nucleus]
- midbrain symptoms
what is the prognosis of a substantial hemorrhage within the brainstem?
- instantly fatal (medulla & pons reticular formation) OR
- coma due to failure of central control of respiration
what is locked in syndrome?
large infarction of ventral pons (basilar a) causing paralysis of all voluntary movements except movements of the eyes
what are the overlapping symptoms of a medial stroke of the medulla and pons?
- contra spastic paralysis (corticospinal in basilar pons/pyramid)
- contra loss of vibration, proprio, etc (ML)
what arteries supply the medial medulla and pons?
anterior spinal (medulla)
short pontine (pons)
what are the symptoms of a medial stroke of the pons only?
- medial strabismus (CN VI)/paralysis of horizontal gaze to side of lesion (inf pons)
- internuclear ophthalmoplegia (MLF)
what are the symptoms of a medial stroke of the medulla only?
ipsilateral tongue paralysis (CN XII)
what arteries supply the lateral medulla and pons?
Posterior inferior cerebellar a (medulla)
Anterior inferior cerebellar a/superior cerebellar (pons)
what are the overlapping symptoms of a lateral stroke of the pons & medulla?
- contra loss of P&T from body (spinothalamic)
- ipsi loss of P&T from face (nucleus of SToV; medulla), touch from face (chief sensory; pons)
- nystagmus (vestibular nuc)
- cerebellar symptoms
- ipsi Horner’s (reticular formation)
- Hiccup (reticular formation)
what are the symptoms of a lateral stroke of the medulla only?
Wallenberg syndrome:
1. dysphagia, hoarseness, uvular deviation or absence of gag reflex (nuc ambiguus, CN X)
2. loss of taste (solitary tract/nuc)
what artery supplies the lateral medulla?
- posterior inferior cerebellar a
- vertebral a
what are the symptoms of a lateral stroke of the lower pons only?
- ipsilateral facial paralysis (bell’s palsy, CN VII)
- deafness (cochlear nuclei)
what artery supplies the lateral lower pons?
anterior inferior cerebellar a
what are the symptoms of a lateral stroke of the midpons only?
inability to chew & jaw deviation (CN V)
name 3 syndromes caused by posterior cerebral strokes
- dorsal midbrain syndrome (Perinaud’s/pinealoma)
- ventral midbrain syndrome (weber’s)
- central midbrain syndrome (claude’s)
symptoms of dorsal midbrain syndrome
- paralysis of upward gaze
- loss of pupillary/light reflex (pretectal nuc)
symptoms of ventral midbrain syndrome
- contra paralysis of body & face (crus cerebri: CST)
- ipsi oculomotor palsy (ptosis, mydriasis, lateral strabismus)
symptoms of central midbrain syndrome
- ipsi oculomotor palsy
- hemiballism (subthalamic nuc)
- contra loss of sensation (P&T, vibration, position)
combination of ventral & central midbrain syndromes is called ____
Benedikt syndrome
