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neurology FA > effects of strokes > Flashcards

effects of strokes Flashcards

1
Q

areas of stroke are divided to

A
  1. anterior circulation

2. posterior circulation

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2
Q

strokes - anterior circulation - arteries

A
  1. middle cerebral artery
  2. anterior cerebral artery
  3. lenticulo-striate artery
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3
Q

stroke on middle cerebral artery - area of lesion

A

motor cortex - upper limb and face
sensory cortex - upper limb and face
termpal lobe - wernicke area
frontal lobe - broca area

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4
Q

stroke on middle cerebral artery - motor cortex - symptoms

A

contralateral paralyisis of upper limb and face

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5
Q

stroke on middle cerebral artery - sensory cortex - symptoms

A

contralateral loss of sensation upper limb and face

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6
Q

stroke on middle cerebral artery - temporal/frontal cortex - symptoms

A

if in dominant –> aphasia

if non dominant –> hemineglect

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7
Q

stroke on anterior cerebral artery - area of lesion

A

motor cortex - lower limb

sensory cortex - lower limb

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8
Q

stroke on anterior cerebral artery - motor cortex - symptoms

A

contralateral paralyisis of the lower limb

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9
Q

stroke on anterior cerebral artery - sensory cortex - symptoms

A

contralateral loss of senseation of lower limb

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10
Q

stroke on lenticulo-striate artery - area of lesion

A
  1. striatum

2. internal capsule

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11
Q

stroke on lenticulo-striate artery - symptoms

A

Contralateral hemiparesis/hemiplegia (face + body)

absence of cortical signs. eg. neglect, aphasia, visual field loss

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12
Q

a common cause of stroke on lenticulo-striate artery - and why

A

2ry to unmanaged hypertension because is a common location of lacunar infarcts

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13
Q

strokes - posterior circulation - arteries

A
  1. anterior spinal artery
  2. posterior inferior cerebellar artery
  3. anterior inferior cerebellar artery
  4. posterior cerebral artery
  5. basilar artery
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14
Q

stroke of anterior spinal artery - area of lesion and symptoms

A
  1. lateral corticospinal tract - contralateral hemiparesis (upper and lower limbs)
  2. medial lemniscus - decreased contralateral proprioception
  3. Caudal medulla/hypoglossal nerve - ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally)
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15
Q

stroke of anterior spinal artery is commonly ….

A

bilateral

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16
Q

medial medullary syndrome is caused by

A

infarct of paramedian branches of anterior spinal artery and vertebral arteries

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17
Q

stroke of posterior inferior cerebellar artery - area of lesion

A 
lateral medulla (Lateral medullary (wallenberg) syndrome): 1. vestibular nuclei 2. lateral spinothalamic tract  3. spinal trigeminal nucleus  4.  nucleus ambiguus (vagus) (μεικτός), 5. sympathetic fibers 
 6. inferior cerebellar peduncle
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18
Q

stroke of posterior inferior cerebellar artery - symptoms

A

vomiting, vertigo, nystagmus, decreased pain and Q sensation from ipsilateral face and contralateral body, dysphagia, hoarness, decreased gag reflex, ipsilateral Horner, ataxia, dysmetria

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19
Q

Lateral medullary (wallenberg) syndrome (specific involvement)

A

POSTERIOR INFERIOR CEREBELLAR ARTERY SYNDROME (STROKE)

nucleus ambiguus effects are specific

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20
Q

stroke of posterior cerebral artery - area of lesion

A

occipital cortex

visual cortex

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21
Q

stroke of posterior cerebral artery - symptoms

A

contralateral hemianopia with macular sparing

22
Q

stroke of basilar artery - area of lesion (areas and structures)

A
  1. pons, medulla, lower midbrain,
  2. corticospinal and corticobulbar (UMN)
  3. ocular cranial nerve nuclei
  4. paramedian pontine reticular formation
23
Q

stroke of basilar artery - symptoms

A

locked-in syndrome :

  1. preserved consciousness, blinking + vertical eye movement
  2. quadriplegia
  3. loss of voluntary facial, mounth and tongue movemetns
24
Q

stroke of anterior inferior cerebellar artery - area of lesion

A

lateral pons: (LATERAL PONTINE SYNDROME)

  • cranial nerve nuclei (vestibular, facal, spinal trigeminal, cochlear,)
  • sympthathetic fibers
  • middle and inferior cerebellar peduncles
  • lateral spinothalamic tract
  • corticospinal tract
25
stroke of anterior inferior cerebellar artery - symptoms
LATERAL PONTINE SYNDROME - vomiting, vertigo, nystagmus - face paralysis, decreased lacrimation and salivation, decreased taste of the anterior 2/3 of the tongue - ipsilateral decreased pain and Q of the face and contralateral of the body - ataxia dysmetria
26
lateral pontine syndrome - specific lesion
facial nucleus
27
lateral medullary (wallenberg) syndrome - artery?
posterior inferior cerebellar
28
posterior communicating artery - lesion
saccular aneurysm | not strokes
29
posterior communicating artery aneurysm - symptoms
CNS III palsy --> eye is down and out with ptosis and mydriasis
30
anterior communicating arteries - lesion
most commonly saccular aneurysm (berry) that can impinge cranial nerves. It can lead to stroke
31
anterior communicating arteries - symptoms
- visual field defects (bitemporal hemianopia) - visual acuity defecits - Rupture --> ischemia in ACA distribution --> contralateral lower extremity hemiparesis, sensory deficits
32
central post-stroke pain syndrome - definition
Neuropathic pain due to thalamic lesions
33
central post-stroke pain syndrome - course
initial paresthesias followed in weeks to months by allodynia and dysesthesia
34
central post-stroke pain syndrome - occurs in
10% of stroke patient
35
10% of stroke patient can experience ...
central post-stroke pain syndrome -
36
allodynia
ordinarily painless stimuli cause pain
37
dysesthesia
abnormal unpleasant sensation felt when touched
38
paresis vs plegia
paresis --> weakness | plegia --> paralysis
39
common locations of lacunar infarcts
1. basal ganglia 2. internal capsule 3. thalamus 4. pons (Oxford handbook)
40
stoke - dysphagia and hoarseness - artery?
posterior inferior cerebellar artery
41
stroke - paralysis of face and loss of lacrimation - artery
Anterior inferior cerebellar artery
42
cause of medial medullary syndrome
infarct of paramedian branches of anterior spinal artery and vertebrate arteries
43
cause of lateral medullary (Wallenberg) syndrome
infarct of posterior inferior cerebral artery
44
cause of lateral pontine syndrome
anterior inferior cerebellar artery
45
stroke - contralateral hemianopia with macular sparing - artery
posterior cerebral artery
46
Lateral medullar (Wallenberg) syndrome - specific lesion
Nucleus ambiguus
47
stroke - locked-in syndrome - artery
Basilar artery
48
CN III palsy by sacular aneyrism - artery
posterior communicating artery
49
most common lesion of anterior communicating artery
aneurysm
50
lesions of posterior communicating artery
Lesions are typically aneyrisms (CN III paralysis) | NOT STROKES

neurology FA (31 decks)

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