Brainstem Strokes

Question 1

2 vertebral arteries give off 3 branches called

Answer 1

Posterior spinal A, anterior spinal A, posterior inferior cerebellar A

Question 2

Vertebral artery

Answer 2

Medulla

Question 3

PICA

Answer 3

Cerebellum, Medulla

Question 4

AICA

Answer 4

Cerebellum, Pons

Question 5

Basilar

Answer 5

Pons, midbrain

Question 6

SCA

Answer 6

Cerebellum, midbrain

Question 7

PCA

Answer 7

Midbrain

Question 8

Cerebellum

Answer 8

SCA, PICA, AICA

Question 9

Midbrain

Answer 9

PCA, SCA, Basilar

Question 10

Pons

Answer 10

Basilar, AICA

Question 11

Medulla

Answer 11

PICA, Vertebral

Question 12

Wallenberg’s Syndrome/Larteral Medullary Syndrome involvement

Answer 12

Rostral/upper medulla including inferior cerebellar peduncle, vestibular nuclei, CN IX & X, Spinal nucleus and tract CN V, Spinothalamic tract, Sympathetic pathways

Question 13

Wallenberg’s Syndrome/Larteral Medullary Syndrome results

Answer 13

Cb signs, vertigo/dizziness, paralysis of pharyngeal & laryngeal muscles, dysarthria, loss of ipsilateral sensation to the face, loss of contralateral pain and temp of body, Horner’s syndrome

Question 14

Wallenberg’s Syndrome/Larteral Medullary Syndrome blood supply

Answer 14

Branches of vertebral A OR branches of posterior inferior cerebellar artery

Question 15

Medial Medullary Syndrome involvement

Answer 15

pyramids, medial lemniscus, CN XII

Question 16

Medial Medullary Syndrome Results

Answer 16

Contralateral body weakness, loss of contralateral discriminative touch/conscious propioception, ipsilateral tongue weakess, diminished gag reflex

Question 17

Medial Medullary Syndrome Blood Supply

Answer 17

ASA and branches of vertebral artery

Question 18

Locked-in Syndrome

Answer 18

Bilateral strokes of pons & perhaps medulla
No voluntary body movement b/c bilateral cortico-spinal involvement
No vocalization
Maintains CN III functions - can blink to command

Question 19

Pontocerebellar Angle Syndrome Involvement

Answer 19

CNVII, CN VIII, cerebellum

Question 20

Pontocerebellar Angle Syndrome results

Answer 20

Ipsilateral vertigo/dizziness/tinnitus, ipsilateral cerebellar signs, ipsilateral facial paralysis

Question 21

Pontocerebellar Angle Syndrome cause

Answer 21

Caused by tumor that affects Schwann cells of CN VIII (acoustic schwanoma)

Question 22

Basal Pontine Syndrome (alternating abducent, facial, or trigeminal hemiplegia) involvement

Answer 22

Corticospinal fibers in basilar pons, cranial nerves in area (abducens, facial, and/or trigeminal), medial lemniscus

Question 23

Basal Pontine Syndrome (alternating abducent, facial, or trigeminal hemiplegia) results

Answer 23

Contralateral hemiplegia, ipsilateral internal strabismus or facial paralysis or loss of facial sensation, contralateral loss of discriminative touch & proprioception

Question 24

Basal Pontine Syndrome (alternating abducent, facial, or trigeminal hemiplegia) blood supply

Answer 24

Branches of anterior inferior cerebellar artery

Question 25

Weber’s Syndrome (alternating oculomotor hemiplegia) involvement

Answer 25

CN III, portions of crus cerebri

Question 26

Weber’s Syndrome (alternating oculomotor hemiplegia) results

Answer 26

External strabismus (paralysis of medial rectus)
Ptosis (no levator palpebrae superioris)
Pupillary dilation (paralysis of constrictor pupillae in CN III)
Contralateral hemiplegia & paralysis of contralateral lower face (due to involvement of corticobulbar fibers)

Question 27

Weber’s Syndrome (alternating oculomotor hemiplegia) blood supply

Answer 27

Posterior cerebral artery