Brainstem Strokes

Question 1

How would a stroke present if the ACA was affected?

Answer 1

Contralateral hemiparesis + sensory loss
Affects lower extremities&raquo_space;> Upper

Question 2

How would a stroke present if the MCA was affected?

Answer 2

Contralateral homonymous hemianopia
Contralateral hemiparesis + sensory loss
Affects Upper extremities&raquo_space;> Lower

If non-dominant side effected - likely to see aphasia

Question 3

How would a stroke present if the PCA was affected?

Answer 3

Contralateral homonymous hemianopia w/ macular sparing
Visual Agnosia (impaired recognition)

Question 4

How would a stroke present if the retinal / ophthalmic artery was affected?

Answer 4

Amaurosis Fugax - Temporary loss of vision in one or both eyes due to a lack of blood flow to the retina

Question 5

How would a stroke present if the basilar artery was affected?

Answer 5

LOCKED IN SYNDROME - Quadriplegic

Question 6

d

Question 7

Describe the vascular innervation of the brain stem? What innervates the midbrain / pons // medulla

Answer 7

Midbrain is supplied by off-branches of the PCA
Pons is supplied by AICA - anterior inferior cerebellar artery
Medulla is supplied by PICA - posterior inferior cerebellar artery

Question 8

What cranial nerves are found in the brainstems’ pons/midbrain and medulla

Answer 8

PONS - 1234
Midbrain 5678
Medulla 9101112

Question 9

Which branch / artery could be affected in a pons stroke?

Answer 9

Basilar Artery causing LOCKED IN SYNDROME
or
AICA - anterior inferior cerebellar artery causing Lateral Pontine Syndrome

Question 10

What would you call a stroke if the AICA artery was affected?

Answer 10

Lateral pontine Syndrome

Question 11

How would a stroke present if the AICA artery was affected?

Answer 11

‘Lateral pontine Syndrome’

Same as Wallenberg syndrome

Ipsilateral facial pain and temperature loss
Contralateral Limb and torso pain and temperature loss
Ataxia
Nystagmus
+
ipsilateral facial paralysis and deafness

Question 12

Which artery is affected in the lateral pontine syndrome

Answer 12

AICA
anterior inferior cerebellar artery

Question 13

Which artery is affected in the Lateral medullary syndrome

Answer 13

PICA
Posterior inferior cerebellar artery

Question 14

What else is lateral medullary syndrome is known as>

Answer 14

Wallenberg Syndrome

Question 14

How would a stroke present if the lateral medullary syndrome?

Answer 14

Affects PICA artery

Sx: DANVAH
D- Dysphagia
A- Ataxia
N- Nystagmus
V- Vertigo
A- Anathesia
H- Horner Syndrome (Ptosis + Miosis) // Hoarse voice

Ipsilateral facial pain and temperture loss
Contralateral limb/torse pain/temp loss
Loss of gag reflex (ipsilateral CN deficit)

Question 15

What would a stroke be called if it occurred in the branches of PCA that supplies the midbrain?

Answer 15

Weber’s Syndrome

Question 16

What artery is affected in a weber’s stroke

Answer 16

PCA branches that supplies the midbrain

Question 17

How would weber’s stroke present?

Answer 17

Ipsilateral CN3 Palsy (Oculomotor) EYES ARE DOWN & OUT
Contralateral weakness of upper and lower extremities

Question 18

How would a lacunar stroke presents?

Answer 18

one of // siolated:
Sensorimotor Stroke
Hemiparesis
Hemisensory Loss
Ataxic hemiparesis
Clumsy hand dysarthia

Question 19

What does DANVAH stands for?

Answer 19

Dysphagia
Ataxia
Nystagmus
vertigo
Anathesia
Horner / Hoarse voice

Question 20

What does DANISH stand for?

Answer 20

Dysdiadokinesia
Ataxia
Nystagmus
Intention Tremor
Slurred Speech
Hypotonia