blood supply to head

Question 1

which artery often gets blocked -> stroke

Answer 1

PICA

Question 2

what on an angiogram would suggest pathology that shouldn’t be there

Answer 2

open communicating arteries

Question 3

what is PICA stroke called

Answer 3

lateral medullary syndromew

Question 4

what are symptoms of lateral medullary yndrome

Answer 4

Patients with PICA territory infarcts most commonly present with acute vertigo, vomiting, headache, gait disturbances, and horizontal nystagmus ipsilateral to the lesion. Headache is the most common initial symptom, and is 20% to 30% more common in PICA distribution infarcts than AICA or SCA infarcts

Also Horner syndrome

Question 5

what is the blood supply to medial medulla

Answer 5

ASA anterior spinal artery

Question 6

what is the blood supply to lateral medulla

Answer 6

PICA

Question 7

main blood supply to pons medial - lateral

Answer 7

basilar medial
AICA lateral

Question 8

main blood supply to midbrain

Answer 8

posterior CEREBRAL artery

Question 9

what are the 4 medial M’s

Answer 9

motor (corticospinal tract)
medial lemniscus (contralateral proprioception)
MLF (eye mvts)
CN motor nerves 3,4,6,12

Question 10

what are the 4 lateral S’s

Answer 10

sympathetic tracts
sensory CN V
spinothalamic tract
spinocerebellar tract

Question 11

what symptoms X SC

Answer 11

ipsilateral ataxia

Question 12

what symptoms X ST

Answer 12

contralateral temp/pain loss

Question 13

what symptoms X CN V

Answer 13

loss of sensation face ipsilateral

Question 14

what symptoms X sympathetics

Answer 14

Ipsilateral Horner’s

Question 15

what symptoms X corticospinal

Answer 15

contralateral mvt loss/weakness

Question 16

what symptoms X MLF

Answer 16

ipsilateral internuclear ophthalmoplegia - + Doll’s Eye reflex

Question 17

what symptoms X ML

Answer 17

loss of contralateral proprioception

Question 18

what does posterior cerebral artery supply

Answer 18

occipital lobe, thalamus, midbrain

Question 19

vertebral artery supplies (brainstem)?

Answer 19

medulla

Question 20

causes of raised intracranial pressure

Answer 20

haemorrhage, tumour, inflammation, berry aneurysm

Question 21

symptoms if brain presses on brainstem

Answer 21

nausea, vomiting, + Babinski, hemiparesis, unconsciousness

Question 22

what can happen if uncus/hippocampus herniate inferiorly

Answer 22

press on CN 3
midbrain pushed to opposite side
PCA occlusino

Question 23

how do you check intracranial pressure

Answer 23

eye

Question 24

what sort of blindness is particular to stroke

Answer 24

homonymous hemianopia (with macular sparing)

Question 25

what are brain arteries like

Answer 25

very thin walls, like veins

Question 26

what is papilloedema what does it look like

Answer 26

volcano appearance of optic disc more angiogenesis, blood vessels don't look like they join up properly

Question 27

which vessel usually implicated in Broca's area impairment

Answer 27

superior division left middle cerebral artery infarct

Question 28

which vessel usually implicated in Wernicke's area impairment

Answer 28

inferior division left middle cerebral artery infarct

Question 29

where does middle cerebral artery originate

Answer 29

starts off as internal carotid, travels out laterally

Question 30

what does MCA supply

Answer 30

basal ganglia, 2/3 cortex, internal capsule

Question 31

which artery supplies occipital lobe

Answer 31

posterior cerebral

Question 32

what if ACA stroke

Answer 32

contralateral legs motor incontinence personality defects

Question 33

what if MCA stroke

Answer 33

motor to rest of body gone contralateral any sort of aphasia depending on location of stroke

Question 34

what does PCA supply

Answer 34

occipital lobe, inf part of temporal and parietal

Question 35

what if PCA stroke

Answer 35

contralateral hemianopia reading and writing defects impaired memory

Question 36

what drains 95% of head blood

Answer 36

saggital sinus

Question 37

where is saggital sinus

Answer 37

inside dura mater (between layers)

Question 38

what is in the cavernous sinus

Answer 38

ICA IJV

Question 39

where do main sinuses meet and where do they go

Answer 39

confluence of sinuses -> internal jugular vein

Question 40

when do you get neglect syndrome

Answer 40

stroke to non-dominant side of head