Compromised Blood Supply to the Brain

Question 1

Term: insufficient blood flow

Answer 1

Ischemia

Question 2

Term: rupture of the vessel and bleeding into the cranial cavity

Answer 2

Hemorrhage

Question 3

Artery Deficit: contralateral hemiplegia and somatosensory loss mainly in the LE, some loss of motivation and executive cognition

Answer 3

Anterior Cerebral Artery

Question 4

Artery Deficit: Contralateral hemiplegia and somatosensory loss in UE and head, aphasia, some loss of executive function and working memory

Answer 4

Middle Cerebral Artery

Question 5

Artery Deficit: Weber’s Syndrome, Hemianopsia

Answer 5

Posterior Cerebral Artery

Question 6

3 Characteristics of Weber’s Syndrome

Answer 6

1. Ipsilateral occulomotor dysfunction (ADD and vertical gaxe, CN III)
2. Pupil dilation
3. Contralateral hemiplegia (descending corticospinal/bulbar tracts)

Question 7

Artery Deficit: Ipsilateral limb/gait ataxia, contralateral loss of pain/temp, ipsilateral Horner’s syndrome

Answer 7

Superior Cerebellar Artery

Question 8

3 Characteristics of Horner’s Syndrome

Answer 8

1. Ipsilateral pupil constriction
2. Ptosis
3. Sinking in of eyeball

Question 9

Artery Deficit: Ipsilateral loss of facial sensation (CN V), ipsilateral Horner’s Syndrome, contralateral hemianesthesia

Answer 9

Anterior Inferior Cerebellar Artery

Question 10

Artery Deficit: Wallenberg’s Syndrome

Answer 10

Posterior Inferior Cerebellar Artery (PICA)

Question 11

5 Characteristics of Wallenberg’s Syndrome

Answer 11

1. Dysphagia and dysarthria (CN XII and X - nucleus ambiguus)
2. Ipsilateral loss of pain/temp of face (CN V)
3. Contralateral loss of pain/temp of body (Spinothalamic tract)
4. Vertigo
5. Ipsilateral Horner’s

Question 12

Artery Deficit: Medial Medullary Syndrome

Answer 12

Anterior Spinal Artery

Question 13

3 Characteristics of Medial Medullary Syndrome

Answer 13

1. Contralateral loss of proprioception (meidal lemniscus)
2. Paresis (UMN in pyramidal tract)
3. Deviation of tongue to side of lesion (CN XII)

Question 14

Artery Deficit: Ipsilateral conscious loss of proprioception, sensory deficits

Answer 14

Posterior Spinal Artery

Question 15

Describe how positions can affect the vertebral arteries

Answer 15

Neck positioning and posture can compress the vertebral arteries ass they pass through the transverse foramina up through the foramen magnum. Extension and rotation can occlude these arteries, especially with bad posture

Question 16

Artery Deficit: nystagmus, dizziness, nausea, blurred vision, LOB/fall

Answer 16

Vertebral artery compromise

Question 17

Describe tPA and it’s effect during stroke

Answer 17

tPA/rtPA or recombinant tissue-type plasminogen activator breaks down blood clots. If adminimsetered within 1 hour (up to 4.5 hr) of onset of stroke pt outcomes improve at 24 hr and 3 month time frames

Question 18

Describe when thromobectomy would be used

Answer 18

Can be used in conjunction with tPA but may also be used if a clot persists after tPA