Brainstem & Lacunar Syndromes. Stroke Mimics

Question 1

Weber

Answer 1

I/L CN 3 and C/L hemiparesis including lower face

Question 2

Benedikt

Answer 2

I/L CN 3 and C/L involuntary movements

Question 3

Nothnagel

Answer 3

I/L CN 3 and C/L dysmetria/ataxia

Question 4

Foville

Answer 4

I/L CN 6/7 w/w/o C/L hemiparesis

Question 5

One and a half

Answer 5

I/L CN 6 with bilateral INO

Question 6

Wallenberg

Answer 6

I/L CN 7,8,9,10, , I/L Horners, I/L ataxia, singultus, C/L body numbness

Question 7

Dejerine

Answer 7

I/L CN 12, C/L hemiparesis w/w/o C/L posterior column

Question 8

Red flags for acute vestibular syndrome

Answer 8

Abnormal HINTs, Four Ds, sudden deaf/tinnitus, neck pain, high risk patient (CAD, Stroke Hx)

Question 9

Pure Motor Stroke Localization (FAL hemiparesis)

Answer 9

C/L hemiparesis Posterior limb of IC

Question 10

Pure Sensory Stroke Localization (FAL hemisensory loss)

Answer 10

C/L sensory, VPL of thalamus

Question 11

Sensorimotor Localization (FAL hemiparesis + sensory loss; no cortical S/sxs)

Answer 11

C/L sensory/motor, thalamus + post limb of IC

Question 12

Dysarthria Clumsy Hand - location/vascular supply

Answer 12

Base of pons - Basilar perforators

Question 13

Ataxic hemiparesis

Answer 13

Ataxia > hemiparesis c/l lower posterior IC in pons

Question 14

Hemiballismus/hemichorea

Answer 14

C/L limb localizes to STN

Question 15

Primary 3 perferator arteries responsible for lacunar syndromes

Answer 15

lenticulostriate (MCA)
Thalamoperforators (PCA)
Basilar

Question 16

Stroke Mimics (6)

Answer 16

Seizures, Encephalopathy, Brain tumor, Neuromuscular, Migraine with aura, psychogenic