BTB CV 1 Flashcards
Main branches of ICA
ophthalmic a.
posterior communicating a.
anterior choroidal a.
anterior cerebral a.
middle cerebral a.
“only penguins are always moving”
ophthalmic artery: anatomy and clinical
eye
amaurosis fugax
anterior choroidal artery: anatomy and clinical
optic tract, posterior limb IC, choroid plexus, medial temporal lobe, globus pallidus, LGB
contralateral hemianopia, contralateral hemiparesis
anterior cerebral artery: main branches
- recurrent artery of Heubner
- pericallosal
- callosomarginal
a1
a2
acom
anterior cerebral artery: anatomy and clinical - perforating branches and cortical branches
medial frontal lobe, corpus callosum, and parts of the basal ganglia
perforating branches: abulia, agitation, dysarthria, hemiparesis
medial aspect of cerebral hemisphere: contralateral LE weakness/sensory loss
pericallosal artery: anatomy and clinical
corpus callosum and the medial surface of the cerebral hemisphere: contralateral LE weakness/sensory loss, potentially cognitive changes - motor slowing, confusion, neglect
callosomarginal artery: anatomy and clinical
medial frontal and parietal lobes
motor and sensory deficits, cognitive impairments, and changes in behavior.
recurrent artery of Heubner: anatomy and clinical
Head of caudate, anterior limb of IC
Head of the Caudate Nucleus: motor control and behavior modulation as part of the basal ganglia.
Anterior Limb of the Internal Capsule:
Contains frontopontine fibers (linking the frontal cortex to the pons) and anterior thalamic radiation (connecting the thalamus to the prefrontal cortex).
Portions of the Putamen: motor regulation
Globus Pallidus (Partially): motor regulation
Septal Nuclei (sometimes): limbic functions, including memory and emotion.
Clinical: Contralateral hemiparesis:
Caused by ischemia affecting the anterior limb of the internal capsule.
Predominantly involves the face and upper extremity due to its connections to corticobulbar and corticospinal tracts.
Behavioral and Cognitive Changes:
Abulia:
Due to involvement of the head of the caudate, a key component of the frontostriatal circuits responsible for motivation and goal-directed behavior.
Apathy or Personality Changes:
Secondary to disruption of basal ganglia-thalamocortical loops.
Dysarthria:
Disruption of corticobulbar pathways passing through the internal capsule.
Limbic Symptoms (less common):
Rare cases may show memory deficits or emotional dysregulation if septal nuclei are involved.
Neglect or Inattention:
Lesions involving the dominant caudate or adjacent structures can result in attentional deficits.
Middle Cerebral Artery (MCA): anatomy and clinical
Perforating branches: basal ganglia and IC, contralateral hemiparesis
Cortical branches: lateral cerebral hemisphere, anterior temporal lobe: face/arm motor/sensory loss, aphasia, Gerstman’s, cortical sensory loss/neglect
The superior division of the MCA supplies the lateral frontal and superior parietal lobes, including the primary motor cortex for the face and arm, Broca’s area, and the frontal eye fields.
The inferior branch of the middle cerebral artery (MCA) :
Contralateral visual field deficit often affecting the upper fields. a “pie in the sky” deficit.
Wernicke’s aphasia
Behavioral disturbance
In the non-dominant hemisphere, behavioral disturbance and impairment of visuospatial skills may occur.
Agitated confusional state
This state may include hyperactivity, restlessness, and easy distractibility
Gerstman’s Syndrome anatomy and clinical
agraphia, acalculia, finger agnosia, R-L confusion
Angular Gyrus (Brodmann Area 39):
The angular gyrus is located near the junction of the parietal, temporal, and occipital lobes.
It is part of the inferior parietal lobule, just posterior to the supramarginal gyrus and near the posterior portion of the Sylvian fissure.
math, language processing, spatial cognition and body awareness
Dominant MCA anterior (superior) division stroke syndrome
hemiparesis, Broca’s aphasia
Dominant MCA posterior (inferior) division stroke syndrome
Hemisensory, Wernicke’s aphasia, Gerstman’s syndrome
Nondominant MCA stroke syndrome
constructional apraxia, neglect, cortical sensory loss
ACA stroke syndrome
LE weakness and sensory loss, apraxia, abulia (bilateral lesions), transcortical motor aphasia (dominant ACA/MCA borderzone)
Anton’s syndrome
cortical blindness, occipital lobe
Callosal disconnection syndrome
interruption of inter hemispheric fibers
Usually left hand: alien hand syndrome, tactile agnosia, visual agnosia, alexia, apraxia
Posterior disconnection syndrome
left unilateral ideomotor apraxia
left constructional apraxia
Anterior disconnection syndrome
alien hand syndrome (usually left)
Pontine Syndromes
Millard-Gubler, Foville
Midbrain Syndromes
Weber, Benedikt
Medullary Syndromes
