Nervous System

Question 1

Stroke presentation Posterior inferior cerebellar artery:

Answer 1

Posterior inferior cerebellar artery: This is going to be your patient who comes in with ataxia, vertigo, nystagmus. Difficulty with finger to nose, not being able to walk (always walk your patients!).

Question 2

Stroke presentation Anterior cerebral artery:

Answer 2

Anterior cerebral artery: this one is difficult because it also results in gait impairment, but it’s from weakness and sensory loss in the contralateral foot. Can also result in mental status changes. But again, remember, this one has sensory loss as well, not just weakness.

Question 3

Stroke presentation Middle cerebral artery:

Answer 3

Middle cerebral artery: contralateral paralysis of the arms and legs, and if on the left side of the brain, you’ll have Wernicke or Broca involvement and have aphasia.

Question 4

Stroke presentation Central venous sinus thrombosis:

Answer 4

Central venous sinus thrombosis is not a typical stroke,
Central venous sinus thrombosis results in overwhelming headache. They also have difficulty speaking and weakness. These patients often have fever and classically “lethargy”. MRA or MRV diagnoses these.