Cerebrovascular Flashcards
Stroke syndrome:
- Quadrantanopsia or hemianopsia
- Transcortical aphasia, or hemi-inattention
MCA/PCA borderzone infarct. Affects temporo-occipital portion of distal MCA territory
![](https://s3.amazonaws.com/brainscape-prod/system/cm/016/901/155/a_image_thumb.jpg?1659400599)
Stroke syndrome:
- producing proximal >> distal sensory & motor deficit in upper extremity, variable lower extremity involvement. Hand and face spared.
MCA/ACA borderzone infarct: affects superficial frontal and parietal parasagittal cortical areas
“Man in a barrel”
![](https://s3.amazonaws.com/brainscape-prod/system/cm/016/901/855/a_image_thumb.jpg?1659400599)
List the divisions of the MCA
M1: Main trunk with deep penetrators and lenticulostriate arteries.
M2: In sylvian fissure where two divisions arise
M3: All cortical branches
M4: Over the cortical Surface
![](https://s3.amazonaws.com/brainscape-prod/system/cm/016/902/247/a_image_thumb.jpg?1659400600)
Stroke syndrome:
A right handed patient with…
- Hemiplegia of right face, arm, and leg
- Hemianesthesia of right side
- Right homonymous hemianopsia
- Deviation of head and eyes to Left
- Global aphasia
Left MCA stem occlusion.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/017/063/218/a_image_thumb.jpg?1659400614)
Stroke Syndrome:
In a right handed patient…
- Left face, arm, leg hemiplegia
- Left sided hemianesthesia
- Left homonymous hemianopsia
- Deviation of head and eyes to right
- Anosognosia and amorphosynthesis
Right MCA Stem occlusion
Image on left is SWI
Image on right is DWI
![](https://s3.amazonaws.com/brainscape-prod/system/cm/017/063/423/a_image_thumb.jpg?1659400614)
Stroke Syndrome:
In a right-handed patient:
- Numbness and weakness of left arm >> leg
- Dysarthria but no aphasia
- Left facial droop
- Right deviation of head and eyes
- Consciousness preserved
Right superior division MCA
- The rolandic branches cause the sensorimotor deficits of the contralateral face and arm >> leg
- Cortical-subcortial branch causes brachial monoplegia
![](https://s3.amazonaws.com/brainscape-prod/system/cm/017/065/006/a_image_thumb.jpg?1659400614)
Stroke Syndrome:
In a right-handed patient:
Numbness and weakness of right arm >> leg
Initial global aphasia, then dysarthria
Right facial droop
Left deviation of head and eyes
Consciousness preserved
Left MCA superior division
- Ascending frontal branch: initial mutism and mild comprehension defect, then dysfluent, agrammatic speech with normal comprehension
- Rolandic branches: sensorimotor paresis with severe dysarthria but little aphasia
- Cortical-subcortical branch: brachial monoplegia
- Ascending parietal: No sensorimotor, just a conduction aphasia
![](https://s3.amazonaws.com/brainscape-prod/system/cm/017/065/432/a_image_thumb.jpg?1659400614)
Stroke Syndrome:
In a right handed patient
- Wernicke’s aphasia
- Superior right quadrantanopsia or hemianopsia
- agitated confusional state
- No weakness or sensory loss
Left MCA Inferior division
This is nearly always from a cardiogenic embolus
Stroke Syndrome:
In a right handed patient
- Left hemi-neglect
- Superior left quadrantanopsia or hemianopsia
- Agitated confusional state
- No weakness or numbness
Right sided inferior division MCA
Nearly always from a cardiogenic embolus
![](https://s3.amazonaws.com/brainscape-prod/system/cm/017/066/548/a_image_thumb.jpg?1659400615)
Stroke Syndrome
- Finger agnosia
- Acalcula
- Right-left confusion
- Alexia +/- agraphia
- Ideational apraxia
Gerstmann’s syndrome
Dominant parietal lobe
Stroke Syndrome:
- Anosognosia
- Autoprosopagnosia
- Hemi-neglect
- Constructional apraxia
- Dressing apraxia
What is the anatomic location (not the cerebrovascular territory)
Non-dominant parietal lobe lesion
Cortical Syndrome:
- docile
- hyperoral
- hypersexual
- hypomobile
- hypermetamorphosis
- visual agnosia
What is the eponym and anatomic location, not the cerebrovascular territory
Kluver-Bucy Syndrome: Bilateral anterior poles of temporal lobes
![](https://s3.amazonaws.com/brainscape-prod/system/cm/017/067/803/a_image_thumb.jpg?1659400616)
Stroke Syndrome:
- Paraplegia (both legs weak)
- Abulia
- Motor aphasia
- Frontal lobe personality changes
ACA stem occlusion proximal to the ACOM (the A1 segment), but only if both arteries arise from one ACA.
Otherwise, the ACOM will allow perfusion of both sides from one ACA and the stroke will be well tolerated.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/017/068/034/a_image_thumb.jpg?1659400616)
Stroke Syndrome:
- Sensorimotor defect of left foot >> shoulder and arm
- Motor defect of foot and leg >> thigh
- Head and eyes deviated to the right
- Urinary incontinence
- Left grasp reflex
- Paratonia (gegenhalten)
ACA stem occlusion in the A2 segment (distal to the ACOM). In this case, the right A2 is involved.
If the left A2 segment is involved, you might see an alien hand too
![](https://s3.amazonaws.com/brainscape-prod/system/cm/017/108/088/a_image_thumb.jpg?1659400635)
Stroke Syndrome:
Transcorticomotor aphasia (halting, one or two word speech, repetition is preserved, writing is impaired)
Heubner’s artery occlusion, a branch of the ACA. This serves the anterior frontal lobe.
Heubner’s artery comes off of the A2 segment just distal to the ACOM
![](https://s3.amazonaws.com/brainscape-prod/system/cm/017/108/208/a_image_thumb.jpg?1659400635)