Neuro - corrections

Question 1

State the criteria for TACS (total anterior circulation)

Answer 1

All 3 of:
- unilateral weakness (and/or sensory deficit)
- homonymous hemianopia
- higher cerebral dysfunction (dysphasia, visuospatial disorder)

Question 2

State the criteria for PACS (partial anterior circulation)

Answer 2

Must have 2 of:
- unilateral weakness (and/or sensory deficit)
- homonymous hemianopia
- higher cerebral dysfunction (dysphasia, visuospatial disorder)

Question 3

What are the arteries affected in a total anterior circulation stroke (TACS)?

Answer 3

• middle cerebral
• anterior cerebral

Question 4

State the criteria for POCS (posterior circulation)

Answer 4

One of following:
- CN palsy & contralateral motor/sensory deficit
- Bilateral motor/sensory deficit
- Conjugate eye movement disorder (e.g. horizontal gaze palsy)
- Cerebellar dysfunction (e.g. vertigo, nystagmus, ataxia)
- Isolated homonymous hemianopia

Question 5

What are the areas supplied by the posterior circulation?

Answer 5

cerebellum & brainstem

Question 6

State the criteria for LACS (lacunar)

Answer 6

Must have one of:
- Unilateral weakness (and/or sensory deficit) of face & arm, arm & leg OR all three
- Pure sensory stroke
- Ataxic hemiparesis

Question 7

Which type of infarct causes ‘locked-in’ syndrome?

Answer 7

Upper brainstem infarct

Question 8

State the presentation of PICA (posterior inferior cerebellar artery stroke)

Answer 8

• acute vertigo
• Contralateral (spinothalamic sensory loss & hemiparesis (rare)
• Ipsilateral (facial numbness (V), diplopia (VI), nystagmus, ataxia, Horner’s syndrome, 9th and 10th nerve lesions)

Question 9

State what the DCML pathway carries

Answer 9

• fine touch
• vibration
• proprioception

Question 10

State what the spinothalamic tract carries

Answer 10

• temperature
• pain

Question 11

State if the DCML decussates & what lesions will present with

Answer 11

NO - ipsilateral losses

Question 12

State if the spinothalamic tract decussates & what lesions will present with

Answer 12

YES - contralateral losses

Question 13

State the treatment for trigeminal neuralgia

Answer 13

Carbamazepine (anti-convulsant)

Question 14

Which antibodies are associated to Lambert-Eaton syndrome?

Answer 14

antibodies to voltage-gated calcium channels

Question 15

Which antibodies are associated to myasthenia gravis?

Answer 15

antibodies to acetylcholine & muscle-specific tyrosine kinase (MuSK)

Question 16

An aneurysm in which vessels can cause presentation of a ‘down and out’ eye?

Answer 16

posterior cerebral
superior cerebellar
(oculomotor nerve runs between them, cause same sided palsy)

Question 17

Which 2 nerves control opening of the eyes?

Answer 17

Levator palpebrae superioris - OCULOMOTOR (more)
Superior tarsal - SYMPATHETIC