blood supply to head Flashcards
which artery often gets blocked -> stroke
PICA
what on an angiogram would suggest pathology that shouldn’t be there
open communicating arteries
what is PICA stroke called
lateral medullary syndromew
what are symptoms of lateral medullary yndrome
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
what is the blood supply to medial medulla
ASA anterior spinal artery
what is the blood supply to lateral medulla
PICA
main blood supply to pons medial - lateral
basilar medial
AICA lateral
main blood supply to midbrain
posterior CEREBRAL artery
what are the 4 medial M’s
motor (corticospinal tract)
medial lemniscus (contralateral proprioception)
MLF (eye mvts)
CN motor nerves 3,4,6,12
what are the 4 lateral S’s
sympathetic tracts
sensory CN V
spinothalamic tract
spinocerebellar tract
what symptoms X SC
ipsilateral ataxia
what symptoms X ST
contralateral temp/pain loss
what symptoms X CN V
loss of sensation face ipsilateral
what symptoms X sympathetics
Ipsilateral Horner’s
what symptoms X corticospinal
contralateral mvt loss/weakness
what symptoms X MLF
ipsilateral internuclear ophthalmoplegia - + Doll’s Eye reflex
what symptoms X ML
loss of contralateral proprioception
what does posterior cerebral artery supply
occipital lobe, thalamus, midbrain
vertebral artery supplies (brainstem)?
medulla
causes of raised intracranial pressure
haemorrhage, tumour, inflammation, berry aneurysm
symptoms if brain presses on brainstem
nausea, vomiting, + Babinski, hemiparesis, unconsciousness
what can happen if uncus/hippocampus herniate inferiorly
press on CN 3
midbrain pushed to opposite side
PCA occlusino
how do you check intracranial pressure
eye
what sort of blindness is particular to stroke
homonymous hemianopia (with macular sparing)
what are brain arteries like
very thin walls, like veins
what is papilloedema what does it look like
volcano appearance of optic disc
more angiogenesis,
blood vessels don’t look like they join up properly
which vessel usually implicated in Broca’s area impairment
superior division left middle cerebral artery infarct
which vessel usually implicated in Wernicke’s area impairment
inferior division left middle cerebral artery infarct
where does middle cerebral artery originate
starts off as internal carotid, travels out laterally
what does MCA supply
basal ganglia, 2/3 cortex, internal capsule
which artery supplies occipital lobe
posterior cerebral
what if ACA stroke
contralateral legs motor
incontinence
personality defects
what if MCA stroke
motor to rest of body gone contralateral
any sort of aphasia depending on location of stroke
what does PCA supply
occipital lobe, inf part of temporal and parietal
what if PCA stroke
contralateral hemianopia
reading and writing defects
impaired memory
what drains 95% of head blood
saggital sinus
where is saggital sinus
inside dura mater (between layers)
what is in the cavernous sinus
ICA IJV
where do main sinuses meet and where do they go
confluence of sinuses -> internal jugular vein
when do you get neglect syndrome
stroke to non-dominant side of head
