Locate lesion of stroke Flashcards
What are the location of tracts in the spinal cord?
What level is the brachial plexus?
C5-T1
Anterior rami of C5 through 1 nerve roots
What level is the lumbosacral plexus?
Anterior (ventral) rami of L1 through S4 nerve roots
Lumbar plexus = L1-L4
Sacral plexus = L4-S4
What level is the sympathetic nervous system?
- Emerges from thoracic and lumbar spinal cord from T1-L2
Bladder storage = T10-L2 (hypogastric nerve)
Thoracolumbar erection center (psychogenic erection by visual input) = T11-L2
Describe the difference between UMN and LMN lesions?
What is the presentation of cerebral cortex lesion?
What are the types of dysphasia and what area is affected?
What are the different cortical signs between left and right sided lesions?
What are the structures involved in the pyramidal system (corticospinal and corticobulbar tract)?
What is the course of corticobulbar tracts (pyramidal tract)?
What are the components of the extrapyramidal system?
What is its function?
What is the presentation of extrapyramidal tract lesion?
What is the function of the cerebellum?
What is the clinical manifestations of cerebellar lesion
In midbrain lesions what may be affected?
CN3,4 palsy
contralateral UMN hemiparesis (corticospinal tract)
Weber syndrome (anterior cerebral peduncle in midbrain)
Parinaud syndrome (dorsal midbrain (tectum))
What will be affected in weber syndrome (anterior cerebral peduncle in midbrain)?
What vessels affected?
Midbrain stroke syndrome due to occluison of paramedian branches of PCA or basilar bifurcation of perforating arteries
Characterized by ipsilateral CN3 palsy and contralateral hemiparesis
Clinical manifestation
Ipsilateral LMN CN3 palsy
Contralateral UMN CN7 palsy (corticobulbar tract)
Contralateral hemiplegia (corticospial tract)
What will be affected in Parinaud syndrome (dorsal midbrain (tectum))?
What causes it?
Clinical manifestation
Loss of vertical gaze
Nystagmus on attempted convergence
Pseudo-Argyll Robertson pupil
Caused by multiple sclerosis, pinealoma or vascular lesion
What is the manifestation of pontine lesion stroke?
- CN5-8 palsy
- Contralateral UMN hemiparesis (corticospinal tract)
- Cerebellar signs (cerebellar peduncle)
- Dysconjugate eye movements (paramedian pontine reticular formation (PPRF)
- Internuclear opthalmoplegia (INO) (medial longitudinal fasciculus)
Paramedian perforating arteries from basilar arteries
What medulla oblongata lesions can be there be?
- CNV,IX–XIIpalsy
- Contralateral UMN hemiparesis (Corticospinal tract)
- Cerebellar signs (Cerebellar peduncle)
What is the cause for lateral medullary syndrome (Wallenberg syndrome)?
What is clinical manifestation?
What are the midbrain syndromes (stroke)?
What are the pontine syndromes (stroke) affected structures and resulting symptoms
What are the pontine syndromes (stroke) affected structures and resulting symptoms
What is clinical feature of stroke affecting putamen?
- Contralateral hemiparesis and paresthesia
- Gaze palsy and homonymous hemianopia
- Aphasia (if dominant hemisphere is affected)
- Hemineglect (if nondominant hemisphere is affected)
- Stupor and coma
What is clinical feature of stroke affecting thalamus?
- Contralateral hemiparesis and paresthesia
- Miotic and unreactive pupils, upgaze palsy with gaze deviation away from the side of the lesion (wrong way eyes)
What is the clinical features of MCA stroke?
What is the clinical features of ACA stroke?
What is the clinical features of PCA stroke?
What is the clinical features of basilar artery stroke?
What is the clinical features of ICA stroke?
- Ipsilateral amaurosis fugax
- Dysphagia, tongue deviates to ipsilateral side (CN XII)
- Numerous contralateral symptoms can occur (e.g., hemiparesis, hemisensory loss, homonymous hemianopsia).
What is the presentation of MCA infarction?
Corticobulbar tracts affected in the primary motor cortex
Somatosensory sensations in the thalamus are transmitted to primary sensory cortex via 3rd order neurons (contains DCML, spinothalamic pathway and trigeminal pathway)
What is the presentation of ACA infarction?
What is the presentation of PCA infarction?
What is the motor homonculus of the primary motor cortex?
What is the sensory homunculus for primary somatosensory cortex?
What is axila section arterial supply of cerebral cortex?
