Effects of Strokes Flashcards
Most common site of berry aneurysm
bifurcation of the Ant comm a.
Rupture of berry aneurysm ==>
SAH “worst headache of my life” or hemorrhagic stroke
Diseases associated with berry aneurysms
ADPKD, Ehlers-Danlos, Marfan’s
Risk factors for berry aneurysms
Advanced age, hypertension, smoking, race (higher in blacks)
Associated with chronic hypertension; affects small vessels (e.g. in basal ganglia, thalamus - lenticulostriate arteries)
Charcot-Bouchard microaneurysm
Problems with aneurysms
compression (on optic chiasm –> bitemporal hemianopia; or other mass effects); stasis of blood –> embolize; spontaneous rupture –> interruption of blood flow/blood –> CSF –> HA
C/L paralysis and loss of sensation of upper limb and face
Aphasia - VESSEL
LEFT (dominant) MCA
C/L paralysis and loss of sensation of upper limb and face
Hemineglect - VESSEL
RIGHT (nondominant) MCA
C/L paralysis and loss of sensation of lower limb - VESSEL
ACA
C/L hemiparesis/hemiplegia - VESSEL
Lateral striate artery - common location of lacunar infarcts secondary to unmanaged HTN
C/L paralysis and loss of sensation of upper limb and face
Aphasia - LOCATION
Motor cortex and Sensory cortex of upper limb and face; (LEFT/DOM) temporal lobe (Wernicke’s) and frontal lobe (Broca’s)
C/L paralysis and loss of sensation of upper limb and face
Hemineglect - LOCATION
Motor cortex and Sensory cortex of upper limb and face; (RIGHT/NONDOM) temporal lobe and frontal lobe
C/L paralysis and loss of sensation of lower limb - LOCATION
Motor cortex and Sensory cortex of lower limb
C/L hemiparesis/hemiplegia - LOCATION
Striatum, internal capsule
C/L hemiparesis of lower limb
DECREASE C/L proprioception
I/L hypoglossal dysfunction (tongue dev. I/L) - VESSEL
ASA of posterior circulation
C/L hemiparesis of lower limb
DECREASE C/L proprioception
I/L hypoglossal dysfunction (tongue dev. I/L) - LOCATION
Lateral corticospinal tract
Medial lemniscus
Caudal medulla (CN XII)
C/L hemiparesis of lower limb
DECREASE C/L proprioception
I/L hypoglossal dysfunction (tongue dev. I/L)
Medial medullary syndrome - caused by infarct of paramedian branches of ASA and vertebral arteries
Medial medullary sydnrome
C/L hemiparesis of lower limb
DECREASE C/L proprioception
I/L hypoglossal dysfunction (tongue dev. I/L)
Caused by infarct of paramedial branches of ASA and vertebral arteries
Vomiting, vertigo, nystagmus DECREASE pain and temp to limbs/face Dysphaia Hoarseness DECREASED gag rflex I/L Horner's syndrome Ataxia Dysmetria (under/over reaching) - VESSEL
PICA of posterior circulation
Vomiting, vertigo, nystagmus DECREASE pain and temp to limbs/face Dysphaia Hoarseness DECREASED gag rflex I/L Horner's syndrome Ataxia Dysmetria (under/over reaching) - LOCATION
LATERAL MEDULLA - vestibular nuclei, lateral spinothalamic tract, spinal trigeminal nucleus, nucleus ambiguus, sympathetic fibers,
INFERIOR cerebellar peduncle (last 2 symptoms)
Lateral medullary (Wallenberg’s) syndrome
Vomiting, vertigo, nystagmus DECREASE pain and temp to limbs/face Dysphaia Hoarseness DECREASED gag rflex I/L Horner's syndrome Ataxia Dysmetria (under/over reaching)
Nucleus ambiguus effects + other stuff
PICA
Vomiting, vertigo, nystagmus Paralysis of face DECREASED lacrimation, salivation, taste ant 2/3 tongue, corneal reflex DECREASED pain/temp of face I/L DECREASED hearing I/L Horner's syndrome Ataxia Dysmetria - VESSEL
AICA of posterior circulation
Vomiting, vertigo, nystagmus Paralysis of face DECREASED lacrimation, salivation, taste ant 2/3 tongue, corneal reflex DECREASED pain/temp of face I/L DECREASED hearing I/L Horner's syndrome Ataxia Dysmetria - LOCATION
LATERAL PONS - Cranial nerve nuclei; vestibular nuclei, facial nucleus, spinal trigeminal nucleus, cochlear nuclei, sympathetic fibers
MIDDLE/INF CEREBELLAR PEDUCLES ( last 2 symp)
Lateral pontine syndrome
AICA of posterior circulation
Facial droop means
AICA’s pooped
Don’t PICA horse(ness) that
can’t eat (dysphagia)
C/L hemianopia with macular sparing - vessel
PCA or posterior circulation
C/L hamianopia with macular sparing - location
Occipital cortex, visual cortex
Visual field defects
AComm - common site of saccular (berry) aneurysm –> impingement on CNs.
CN III palsy (eye “down an out” with ptosis and pupil DILATION)
PComm - common site of saccular (berry) aneurysm
