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STEP 1 > Brain Lesions > Flashcards

Brain Lesions Flashcards

1
Q

Disinhibition (gambling, spending, fighting, hyper-sexual etc.) and deficits in concentration, orientation, judgment;

may have reemergence of primitive reflexes

A

Frontal Lobe Lesion

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2
Q

Destructive lesions of Frontal Eye Field disrupts conjugate horizontal gaze leading to eyes looking ___ brain lesion side caused classically by MCA stroke

(aka: away from side of hemiplegia/paralysis)

A

toward

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3
Q

Eyes look away from brain lesion (constantly looking to one side, but can’t look to the other side)
(aka toward side of hemiplegia)

Ex) LEFT side brain lesion = Eyes can only look RIGHT = Hemiplegia/paralysis on the RIGHT.

A

Paramedian pontine reticular formation

lesion in the PONS

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4
Q

Internuclear ophthalmoplegia (impaired adduction of ipsilateral eye; nystagmus of contralateral eye with abduction)

Ex) LEFT eye can move to the left, but the right eye stops at midline (nystagmus) so lesion on the LEFT side). LEFT eye can’t adduct, but right eye can abduct).

A

Medial Longitudinal Fasciculus

Buzzword for Multiple Sclerosis

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5
Q

Agnosia (can’t acknowledge it) of the contralateral side of the world causing Hemi-neglect Syndrome

A

NONDOMINANT parietal Cortex

aka left handed person has a left handed lesion

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6
Q

Anterograde amnesia—inability to make new memories

A

BILATERAL Hippocampus

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7
Q

May result in tremor at rest, chorea, athetosis

A

Basal Ganglia lesion

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8
Q

Substantia Nigra Pars compacta damage (Basal Ganglia)

A

Parkinson’s

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9
Q

Cuadate Nucleus damage (Basal Ganglia)

A

Huntington Disease

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10
Q

Subthalamic Nucleus damage (Basal Ganglia)

A

Contralateral Hemiballismus

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11
Q

Confusion, Ataxia, Nystagmus, Ophthalmoplegia, memory loss (anterograde and retrograde amnesia), confabulation, personality changes

A

BILATERAL MAMMILLARY BODIES damage

Wernicke-Korsakoff syndrome

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12
Q 
disinhibited behavior (ex: hyperphagia, hypersexuality, hyperorality) 
HSV-1 ENCEPHALITIS
A

BILATERAL AMYGDALA damage

Klüver-Bucy syndrome

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13
Q

vertical gaze palsy, pupillary light-near dissociation, lid retraction, convergence-retraction nystagmus

A

Superior Colliculi in DORSAL Midbrain

Parinaud Syndrome

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14
Q

Stroke, Hydrocephalus, Pinealoma can compress

A

Superior Colliculi in DORSAL Midbrain

No more vertical gaze

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15
Q

Reduced levels of arousal and wakefulness or
Coma
may precede a tear of Middle Meningeal artery

A

Reticular Activating System (midbrain)

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16
Q

Intention tremor, limb ataxia, loss of balance;ipsilateral deficits; fall toward side of lesion

A

Lateral Cerebellar Hemisphere (so NOT the vermis)

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17
Q 
Truncal ataxia (wide-based,“drunken sailor” gait even with eyes open), nystagmus
Degeneration associated with chronic alcohol use
A

Cerebellar Vermis degeneration

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18
Q

Decorticate (flexor) posturing—flexion of upper extremities and extension of lower extremities

A

lesion above red nucleus (midbrain)

Ex: cerebral hemispheres, internal capsule

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19
Q

Decerebrate (extensor) posturing—extension of upper and lower extremities

A

lesion at or below red nucleus

Ex: midbrain to pons

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20
Q

Which posturing (Decorticate/Decerebrate) has a worse prognosis?

A

Decerebrate

21
Q

Wernicke’s Aphasia: impaired language comprehension, fluent, but non-sensical speaking.

A

DOMINANT

Superior Temporal Gyrus lesion

22
Q

Prosopagnosia (unable to recognize faces)

A

Fusifrom Gyrus lesion

runs along the bottom of the brain from the temporal to the occipital lobe

23
Q

irreversible neuron damage occurs after how many minutes of hypoxia?

A

5 minutes

24
Q

What are the 4 most vulnerable areas to hypoxia in order of most to least?

A

HIPPOCAMPUS
Neocortex
Purkinje Cells (Cerebellum)
Watershed Areas

(Vulnerable hippos need pure water)

25
Q

24 hours or less after brain ischemia shows what?

2

A

EOSINOPHILIC
Pynknotic nuclei
(aka Red Nuclei)

26
Q

2-3 days after brain ischemia shows what?

2

A

Necrosis

Neutrophils

27
Q

4-5 days after brain ischemia shows what?

1

A

Macrophages (Macroglia)

28
Q

1-2 weeks after brain ischemia shows what?

2

A 
Reactive Gliosis (astrocytes, microglia etc proliferation)
Vascularization
29
Q

> 2 weeks after brain ischemia shows what?

1

A

Fibrotic Glial Scar

30
Q 
Decreased pain/temp from CL body and IL face
Horner Syndrome
Dysphagia
Hoarseness
decreased gag reflex
A

PICA
Wallenberg
*don’t PICA wHORe that can’t Eat or Sing

PICA lesion - MEDULLA
1. Dysphagia/Dysarthria:
Nucleus ambiguous CN IX and X
2. Ipsilateral facial anesthesia/thermanesthesia: Spinal nucleus and tract of Trigeminal nerve
3. Contralateral anesthesia/thermanesthesia: ALS
4. Vertigo & ocular disturbances: Vestibular nuclei
5. Ipsilateral ataxia: Inferior cerebellar peduncle
6. Ipsilateral Horner syndrome

31
Q

neuropathic pain d/t thalamus. Initial paresthesias followed by allodynia and dysesthesia

A

Central post-stroke pain syndrome

32
Q

spastic hemiparesis of CL side and weakness of lower two thirds of the face

A

internal capsule lesion

33
Q

Agraphia
Acalculia
Finger agnosia
L–R disorientation

A

Dominant parietal cortex
(Dominant Angular & Supramarginal gyri)
Gertsmann syndrome

34
Q

stroke affecting nucleus ambiguus is specific for a lesion to which artery?

A

PICA

35
Q

Homonculus (medial vs lateral)

A 
medial = limbs
lateral = face
36
Q

Epidural Hematoma looks like a ___ on CT

A

Lens (bioconvex/Lentiform)

37
Q

Subdural Hematoma looks like a ___ on CT

A

Crescent moon (banana)

38
Q

Subarachnoid Hemorrhage looks like a ___ on CT

A

Diffuse Hyperdensity deep in the deep brain or periventricular

39
Q

Intraparenchymal Hemorrhage looks like a ___ on CT

A

Well circumscribed hyperdense blob in the deep brain

40
Q

Due Long term Hypertension & 2nd most common cause of elderly dementia

A

Intraparenchymal Hemorrhage

41
Q

Increased risk due to Marfan, Ehler Danlos, Polycystic Kidney disease, Smoking, or HTN

A

Subarachnoid Hemorrhage

42
Q

Due to Rupture of Bridging veins

A

Subdural Hematoma

Crescent moon

43
Q

Has a lucid interval. often involves a fractured pterion (lateral skull).

A

Epidural Hematoma

lens shaped

44
Q

Can progress to transtentorial herniation and CN III palsy

A

Epidural Hematoma

lens shaped

45
Q

a completely closed eyelid and deviation of the eye outward and downward. The eye cannot move inward or up, and the pupil is typically enlarged and does not react normally to light.

A

CN III palsy

46
Q

Seen in shaken babies

A

Subdural Hematoma

Crescent moon

47
Q

Bleed crosses suture lines

A

Subdural Hematoma

Crescent moon

48
Q

Bleed does NOT cross suture lines

A

Epidural Hematoma

lens shaped

49
Q

Alcoholism can cause chronic rupture of bridging veins leading to a hypodense ____ on CT

A

Subdural Hematoma

Crescent moon

STEP 1 (88 decks)

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