Effects of Strokes

Question 1

What arteries make up the anterior circulation?

Answer 1

• Middle Cerebral
• Anterior Cerebral
• Lateral Striate

Question 2

Middle Cerebral Artery blockage prevents blood flow where?

Answer 2

• Motor Cortex for Upper Limb and Face
• Sensory Cortex for Upper Limb and Face
• Temporal Lobe (Wiernicke’s area)
• Frontal Lobe (Broca’s)

Question 3

Symptoms of Middle Cerebral artery stroke

Answer 3

Contralateral paralysis in upper limb and face
Contralateral sensory loss in upper limb and face
Aphasia if in dominant hemisphere.

Question 4

Anterior Cerebral artery blockage prevents blood flow where

Answer 4

Motor cortex- lower limb

Sensory cortex Lower limb

Question 5

ACA stroke symptoms

Answer 5

Loss of motor and sensory in lower limb

Question 6

Lateral Striate Artery supplies what

Answer 6

Striatum, internal capsule

Question 7

Lateral striate artery stroke symptoms

Answer 7

Contralateral hemiparesis

Question 8

Lateral striate artery strokes commonly occur when?

Answer 8

When HTN is unmanaged and you have lacunar infarcts.

Question 9

Posterior Circulation made up by which arteries>

Answer 9

• Anterior Striate Artery
• Posterior Inferior Cerebellar Artery
• Anterior Inferior Cerebellar Artery
• Posterior Cerebellar Artery

Question 10

Anterior Striate Artery supplies blood where

Answer 10

Lateral corticospinal tract
Medial lemniscus
Caudal medulla

Question 11

ASA stroke symptoms

Answer 11

contralateral hemiparesis- lower limbs

contralateral proprioception

Ipsilateral hypoglossal dysfunction

Question 12

ASA stroke commonly bilateral, called Medial medullary syndrome—

Answer 12

caused by the infarct of paramedian branches of ASA and vertebral arteries

Question 13

PICA supplies blood where

Answer 13

Remember the PICA comes off of the vertebral arteries pretty low…supplies blood to the lateral medulla, so:
vestibular nuclei, lateral spinothalamic tract, spinal trigeminal, nucleus ambiguus, sympathetic fibers, inferior cerebellar peduncle

Question 14

Symptoms of PICA bockage

Answer 14

Vomitting, vertigo, nystagmus,
Decreased pain and temp to face and limbs
dysphagia, hoarseness
ipsilateral horners

Question 15

What is Wallenburg’s syndrome?

Answer 15

Lateral medullary syndrome-

Nucleus ambiguus effects are specific to what lesion?

PICA….Don’t PICA Horse (hoarseness) that can’t eat (dysphagia). Both a result of nucleus ambiguus

Question 16

AICA supplies blood where

Answer 16

Lateral Pons-

• cranial nerve nuclei
• vestibular nuclei
• facial nucleus
• spinal trigeminal nucleus
• cochlear nuclei
• sympathetic fibers

Question 17

Facial nucleus effects are specific to what lesion?

Answer 17

Lateral Pontine Syndrome—AICA lesions

Facial droop means AICA’s pooped

Question 18

PCA supplies blood where

Answer 18

occipital cortex

Question 19

PCA stroke symptoms

Answer 19

contralateral hemianopsia with macular sparing

Question 20

Berry Aneurysms most commonly occur where?

Answer 20

At bifurcations in the Circle of Willis- most commonly at the bifurcation of the anterior comunicating artery.

Question 21

Rupture of a berry aneurysm leads to

Answer 21

subarachnoid hemorrhage or hemorrhagic stroke

Question 22

Berry aneurysms and the optic chiasm?

Answer 22

May compress the optic chiasm and lead to “bitemporal hemianopia”

Question 23

Charcot Bouchard microaneurysm?

Answer 23

associated with chronic hypertension. Affects small vessels in the basal ganglia and thalamus.