Clinical Stroke Syndrome

Question 1

Understanding clinical syndromes associated with defined cerbrovascular lesions in ischemic stroke can?

Answer 1

Valuable too in rehab

Question 2

The anatomic distribution of the Middle Cerebral Artery include?

Answer 2

Large proportion of cerebral cortex and ischemia within MCA imparts significant impairment and disability, requiring rehab

Question 3

MCA is particularly vulnerable to?

Answer 3

Cardioembolic and thromboembolic diseases

Question 4

Impairments after occlusion of the MCA main stem (M1 segment) include?

Answer 4

Contralateral hemiplegia
Contralateral hemianesthesia
Contralateral hemianopsia
Head or eye turning toward lesion
Dysphagia
Uninhibited neurogenic bladder
DOMINANT HEMISPHERE
global aphasia, apraxia
NONDOMINANT HEMISPHERE
aprosody and affective agnosia, visuospatial deficit, neglect syndrome

Question 5

Hemiplegia in a main stem stroke is?

Answer 5

Complete, affecting upper and lower limbs and lower portions of face equally.

Question 6

Results primarily from? Main stem mca

Answer 6

Ischemia from within the deep lenticulostriate circulation to posterior limb of the internal capsule through which descending fibers of primary motor cortex pass.

Question 7

Sensory deficits can be significant because?

Answer 7

Ascending sensory fibers are injured as well, but deep pain sensation can be intact.

Question 8

mcA perforators supply only what part of visual radiations? Thus?

Answer 8

Upper half of visual radiations, but complete hemianospsia is frequently described.

Question 9

Anterior circulation- brain consists of?

Answer 9

Both internal carotid derived from the right and left common carotid arteries.
Right carotid is usually a branch of the right subclavian, the left is a direct branch of the aorta.

Question 10

After internal carotid passes intracranially towards the carotid siphon?

Answer 10

It provides the ophthalmic branch to the orbit andforms anastomosis of the circle of Wilis with the ipsilateral posterior communicating artery.

Question 11

The internal carotid then bifurcates into?

Answer 11

Anterior cerebral artery (aca) and mca.

Question 12

MCA STEM or M1 segments turn laterall, passing along?

Answer 12

The base of the brain to Sylvian fissure overlying the insular cortex, where it typically bifurcates into upper and lower division.

Question 13

Along path of M1 segment, small, deep, perforating branches called lenticulostriate arteries are supplied to?

Answer 13

Putamen, globus pallidus, caudate and internal capsule

Question 14

M2 segment comprises?

Answer 14

Upper and lower divisions of the MCA as they travel posteriorly and superiorly along the insular cortex.

Question 15

MCA upper divison stokes?

Answer 15

Contralateal hemiplegia
Contralateral hemianesthesia
Contralateral hemianopsia
Head or eye turning toward lesion
Dysphagia
Uninhibited neurogenic bladder
DOMINANT HEMISPHERE
broca aphasia
Apraxia
NONDOMINANT HEMISPHERE
aprosody
Visuospatial deficit
neglect syndrome

Question 16

In mca upper divison, Clinical presentation is very similar to that of mainstem infarction, but?

Answer 16

Hemiplegia and language comprehension deficits are usually not as severe.

Question 17

In upper divison, Because m1 segment of mca is spared, vascular supply to internal capsule is?

Answer 17

Preserved, ischemia is limited to the inferolateral portion of the primary motor cortex. As a result motor strength and control ar e better in lower limb than in hand and face.

Question 18

Anatomic location of lesions within the cns predicts?

Answer 18

Physical or cognitive impairment and disability

Question 19

A classic broca type aphasia is typical in? Upper div

Answer 19

A dominant hemisphere stroke, and aprosodia without affective agnosia is founf in nondominant hemisphere stroke

Question 20

Branch obstruction of the mca lower division is?

Motor sensory function?

Answer 20

Much less common than upper division stroke and usually caused by embolic event.
Generally intact

Question 21

Stroke of mca lower division can still have?

Answer 21

Significant functional disability from impaired language and vision, poor awareness of deficits.

Question 22

Middle carabral artery stroke: lower division

Answer 22

Contralateral homonymous hemianopsia
dominant hemisphere
- wernicke aphasia
Nondominant hemisphere
- affective agnosia

Question 23

Wernicke’s aphasia?

Answer 23

sensory aphasia, is a type of aphasia in which people with the condition are unable to understand language in its written or spoken form, and even though they can speak with normal grammar, syntax, rate, and intonation, they cannot express themselves meaningfully using language.

Question 24

Broca’s aphasia

Answer 24

Expressive aphasia (non-fluent aphasia) is characterized by the loss of the ability to produce language (spoken or written).

Expressive aphasia is also known as Broca’s aphasia in clinical neuropsychology and agrammatic aphasia in cognitive neuropsychology and is caused by acquired damage to the anterior regions of the brain, including (but not limited to) the left posterior inferior frontal gyrus or inferior frontal operculum, also described as Broca’s area (Brodmann area 44 and Brodmann area 45)[2]

Question 25

Global aphasia

Answer 25

Global aphasia is a type of language disorder caused by damage to the brain. It is a nonfluent aphasia with severe impairment of both expressive and receptive skills.

Question 26

Apraxia

Answer 26

Apraxia is a motor disorder caused by damage to the brain (specifically the posterior parietal cortex), in which someone has difficulty with the motor planning to perform tasks or movements when asked, provided that the request or command is understood and he/she is willing to perform the ta

Question 27

Agnosia

Answer 27

Inability to process sensory information