CNS Blood Supply

Question 1

What does the superior cerebellar artery supply?

Answer 1

Superior cerebellum and some midbrain

Question 2

In general, a stroke in one of the branches of the internal carotid artery will present as what kind of deficit?

Answer 2

Contralateral sensory and motor loss based on homunculus

Question 3

An occlusion in what artery on what side may cause language deficits?

Answer 3

Middle cerebral artery on the left side

Question 4

Medial Medullary/Inferior Alternating/Dejerine’s Syndrome:
What artery is occluded?
What deficits may a patient experience?

Answer 4

Anterior spinal artery
C/L: Corticospinal
C/L: medial lemniscus (loss of touch, pressure, vibration)
I/L: Hypoglossal nucleus (flaccid paralysis of tongue to side of lesion)

Question 5

Lateral Medullary/Wallenburg’s Syndrome

Answer 5

PICA
I/L pain and temperature sensations from the face
C/L pain and temperature from body
Horner's Syndrome
decreased taste
hearing loss
General ataxia
nausea
vertigo
nystagmus
hoarseness
dysphagia

Question 6

Lateral Pontine Syndrome:

Answer 6

AICA (basilar artery)

I/L pain and temperature sensations from the face
C/L pain and temperature from body
Horner’s Syndrome (ptosis, miosis, anhydrosis)
nystagmus

Same as Wallenberg but no loss of taste or hoarseness of voice

Question 7

What nuclei are affected in lateral medullary syndrome that are not affected in lateral pontine syndrome?
What is the difference in presentation?

Answer 7

Nucleus ambiguus and nucleus solitarius

Lateral medullary syndrome leads to dysphagia, hoarseness and loss of taste while lateral pontine syndrome does not

Question 8

Medial Midbrain/Superior Alternating/Weber’s Syndrome:

Answer 8

PCA (basilar)

I/L oculomotor nerve palsy (down and out)– occulomotor nerve palsy
C/L hemiplegia (corticospinal)

Question 9

Benedikt’s Syndrome

Answer 9

PCA (more severe)

I/L oculomotor nerve palsy (down and out)
C/L hemiplegia
Ataxia

Question 10

What arteries make up the Circle of Willis?

Answer 10

Anterior cerebral
Anterior communicating
Internal carotid
Posterior communicating
Posterior cerebral

Question 11

Watershed Zones:
What is it?
What happens in one-vessel occlusion?

What happens in two-adjacent-vessel occlusion?

Answer 11

Region of the brain receiving dual blood supply
Ischemia occurs in region supplied by single vessel, but not in WSZ

Ischemia and infarction in WZS