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Neuro 1 > CVA Clinical Syndromes > Flashcards

CVA Clinical Syndromes Flashcards

1
Q

What lobe is affected with ACA stroke? What does this cause?

A 
- frontal lobe which causes cognitive deficits like:
Agitation
Memory impairments
Executive Function impairments 
Attention deficits 
Emotional lability/lack of emotional regulation
Motor perseveration
Lack of spontaneity
Delayed processing
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2
Q

What part of the body is impacted more with ACA stroke? What side will symptoms present on?

A

LE > UE b/c interior part of brain (homunculus)

pt will have contralateral hemiplegia and hemisensory loss

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3
Q

What are some common signs and symptoms of an ACA stroke?

- What side will they occur on?

A
  • apraxia - difficulty w/ skilled movements (dominant/left > nondominant/right)
  • transcortical aphasia - stuttering speech - damage to sup. motor area
  • contralateral grasp and sucking reflexes
  • urinary incontinence
  • visual deficits
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4
Q

Medial medullary syndrome stroke artery involved

A

vertebral artery

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5
Q

Lateral medullary syndrome (Wallenberg’s Syndrome) artery involved

A

PICA

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6
Q

Medial Inferior Pontine Syndrome artery involved

A

Basilar artery

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7
Q

Lateral Inferior Pontine Syndrome artery involved

A

AICA

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8
Q

What is the only stroke that has hearing involvement?

A

lateral inferior pontine syndrome

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9
Q

lateral superior pontine syndrome artery involved

A

superior cerebellar artery

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10
Q

vertebrobasilar artery syndrome (locked-in syndrome) artery involved

A

basilar artery/posterior circulation

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11
Q

lacunar infarcts artery involved

A

lenticulostriate arteries off MCA

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12
Q

What part of the body is impacted more with MCA stroke? What side will symptoms present on?

A
  • UE > LE

- contralateral hemiplegia and hemisensory loss

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13
Q

What are common S & S of MCA stroke?

A
  • dysarthria (slurring of speech bc of facial deficits)
  • apraxia and aphasia (dominant > nondominant)
  • perceptual deficits (nondominant > dominant) - agnosias, neglect, spatial disorientation
  • behavior impairments
  • visual deficits
  • contralateral dysconjugate gaze
  • sensory ataxia
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14
Q

Which side of the brain is more commonly affected by MCA apraxia and aphasia?

A

dominant (left) > nondominant (right)

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15
Q

Which side of the brain is more commonly affected by perceptual deficits after MCA stroke?
What kind of deficits are they?

A

nondominant (right) > dominant (left)

- agnosias, neglect, spatial disorientation

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16
Q

If MCA stroke occurred on the left side of the brain, what kind of behavior would the patient have?

A

dominant side - cautious behavior

17
Q

If MCA stroke occurred on the right side of the brain, what kind of behavior would the patient have?

A

nondominant side - impulsive behavior

18
Q

What kind of impairments would you see with Superior MCA stroke?

A
  • motor impairments (motor cortex)
  • behavior impairments (frontal)
  • perception impairments (parietal)
19
Q

What kind of impairments would you see with Inferior MCA stroke?

A
  • walkie talkie - walk normally w/ no motor impairments but talk gibberish due to Wernicke’s and speech impairments
  • may have some facial impairments based on the homunculus
20
Q

What are common S & S of lacunar infarcts? What occurs if internal capsule or basal ganglia are damaged?

A

motor impairments

  • NO SENSORY, no behavior, no coordination if internal capsule damaged
  • Significant motor control & motor planning deficits if basal ganglia damaged
21
Q

What are common S & S of PCA stroke?

A
  • vision
  • visual agnosia (dominant > nondominant)
  • Prosopagnosia (face blindness)
  • dyslexia
  • memory (temporal)
  • Topographical disorientation (nondominant > dominant)
22
Q

What side is affected more with PCA stroke when it comes to visual agnosia and Topographical disorientation?

A
  • visual agnosia - dominant > nondominant

- Topographical disorientation - nondominant > dominant

23
Q

What will you see with deep PCA stroke?

A
  • thalamic pain
  • Spontaneous pain & dysesthesias
  • involuntary movements
  • contralateral hemiplegia
  • motor and sensory impairments
24
Q

What is the cause of watershed infarcts?

A

severe/sudden drops in BP

25
Q

What is the result of ACA-MCA watershed infarct?

A
  • proximal limb involvement - “man in barrel syndrome”

- dominant hemisphere - transcortical aphasia

26
Q

What is the result of MCA-PCA watershed infarct?

A

disturbances in higher-order visual processing

27
Q

What are common S & S of right-sided hemispheric strokes?

A
  • easily agitated, poor insight, impulsive
  • need bed alarms
  • visual issues
  • memory, abstract thought, problem solving
28
Q

What are common S & S of left-sided hemispheric strokes?

A
  • more cautious and nervous
  • more guarded and move slowly
  • speech and language impairments
  • Disorganized problem solving/difficulty planning sequence
  • Ideational and ideamotor
29
Q

medial medullary syndrome S & S

A

vertebral artery

  • ipsilateral tongue weakness
  • contralateral UE/LE weakness
  • contralateral UE/LE sensory loss (dorsal column)
30
Q

lateral medullary (Wallenburg’s) syndrome S & S

A

PICA

  • Ipsilateral facial pain/temp loss
  • contra UE/LE sensory loss (dorsal and anterolateral system)
  • ipsi ataxia
  • vertigo, N/V
  • nystagmus
  • dysphagia, dysphonia, impaired gag reflex
  • ipsi Horner’s (miosis, ptosis, anydrosis)
31
Q

medial inferior pontine syndrome S & S

A

Basilar artery

Ipsilateral
- paralysis of conjugate gaze to side of lesion
- nystagmus
- ataxia of limbs and gait
- diplopia on lateral gaze (double vision)
- ipsi abducens damage
Contralateral
- facial and UE/LE weakness
- contra sensory facial and UE/LE sensory loss - dorsal column

32
Q

lateral inferior pontine syndrome S & S

A

AICA

Ipsilateral
- nystagmus
- vertigo, N/V
- facial weakness
- Paralysis of conjugate gaze to side of lesion
- deafness, tinnitus
- ataxia
- ipsi facial sensory loss (CN 5)
Contralateral
- facial and UE/LE sensory loss - anterolateral system
33
Q

lateral superior pontine syndrome S & S

A

superior cerebellar artery

Ipsilateral
- cerebellar ataxia of limbs and gait, falling to side of lesion - lateropulsion
- ipsi ataxia - lateropulsion
- dizziness, nausea, vomiting
- nystagmus
- paresis of conjugate gaze
- Horner's syndrome
Contralateral
- facial pain/temp loss
- contra LE>UE sensory loss - dorsal column
34
Q

vertebrobasilar artery syndrome (locked-in syndrome) S & S

A
  • tetraplegia
  • bilateral cranial nerve palsy, upward gaze and blink is spared
  • coma
  • cognition is spared
35
Q

Which sided stroke will have problems expressing negative emotions? positive emotions?

A

negative = right

positive = left

36
Q

miosis

A

excessive constriction of the pupil of the eye

37
Q

ptosis

A

upper eyelid droops over the eye

38
Q

anhydrosis

A

inability to sweat normally

Neuro 1 (11 decks)

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