Coma and Altered Mental Status, and stroke localization Flashcards
Persistent vegetative state
May follow a prolonged coma and is characterized by preserved sleep-wake cycles and maintenance of autonomic functions, with absence of awareness and cognition.
locked in syndrome
awareness and cognitive function are preserved but almost complete paralysis occurs. Is often caused by large lesions in the base of the pons.
brain death
A declaration of death based on irreversible cessation of all brain functions.
vertebrobasilar artery infarction
Either isolated or combined cerebellar or brainstem signs, Can include vertigo, diplopia, nystagmus, weakness or numbness of the extremities, ataxi, vomiting, occipital headache or chrossed motor or sensory. findings. A classic example is wallenberg syndrome.
Wallenberg Syndrome
This is a dorsolateral medullary infarction usually caused by verebral artery occlusion. Ipsilateral ataxia, ipsilateral horner’s syndrome and ipsilatteral facial sensory loss with contrlateral impariment of pain and temperature in the arm and leg. Patient usually has nystamus and vertigo, may have hiccups or difficulty swallowing.
Lesion of the Left PCA
usually right sided visual field defect, sensory loss on right (if thalamus is involved), difficulty naming colors presented visually, alexia without agraphia if splenium of corpus collosum is involved.
Lesion of the right PCA
Left-sided visual field cut and left sided sensory loss if thalamus is involved. May also be assc’d neglect.
Left hemisphere lesion
right sided weakness and sensory loss, right visual firld cut, inability to gaze to the right, and aphasia. possible impariment of reading, righting and calculation.
Right hemisphere lesion
left-sided weakness and sensory loss, gaze deviation to the right, neglect of left, corticosensory defects like extinction of stimuli), difficulty drawing or copying, and aprosodic speech.
Pure motor stroke
posterior limb of internal capsule
Pure sensory stroke
contralateral thalamus.
