Neuro Lesions Flashcards
In normal pressure hydrocephalus, expansion of ventricles distorts the _____
fibers of the corona radiata
Stroke of the ___ artery causes:
Contralateral paralysis and sensory loss–face and upper limb.
Aphasia if in dominant hemisphere. Hemineglect if in nondominant hemisphere.
Middle Cerebral Artery
Sx:
headache, tinnitus, diplopia, no change in mental status, papilledema
Enlarged blind spot and peripheral constriction
Idiopathic Intracranial Hypertension
Stroke of the ___ artery at the _____ causes:
Decreased pain and temperature sensation from contralateral body, ipsilateral face
Posterior Inferior Cerebellar A.
Lateral spinothalamic tract, spinal trigeminal nucleus
(Lateral Medulla)
Tx for restless leg syndrome?
Pramipexole, ropinirole
Stroke of the ____ artery causes:
Contralateral hemianopia with macular sparing;
alexia without agraphia (dominant hemisphere)
Posterior cerebral
Parinaud syndrome is caused by a lesion of the ______
dorsal midbrain
Athetosis (slow, snake-like, writhing movements; especially seen in fingers) is caused by a lesion of the ____
Basal Ganglia
Chorea (sudden, jerky, purposeless movements) is caused by a lesion of the ____
Basal Ganglia
May result in tremor at rest, chorea, athetosis
Lesion of Basal Ganglia (Parkinson disease, Huntington disease)
Visual hallucinations, dementia with fluctuating cognition/alertness, REM sleep behavior disorder, and parkinsonism
Lewy Body dementia
Agnosia of the contralateral side of the world
Lesion of Nondominant parietal cortex
aka Hemispatial Neglect Syndrome
Stroke of the ___ artery at the _____ causes:
Anterior Inferior Cerebellar A.
Spinothalamic tract, spinal trigeminal nucleus (Lateral pons)
impaired adduction of ipsilateral eye; nystagmus of contralateral eye with abduction
internuclear opthalmoplegia
Confusion, ataxia, Nystagmus, Opthalmoplegia, memory loss (anterograde and retrograde amnesia), confabulation, personality changes
Wernicke-Korsakoff syndrome
Stroke of the ___ artery at the _____ causes:
Ipsilateral ataxia, dysmetria
Posterior Inferior Cerebellar A.
Inferior cerebellar peduncle (Lateral Medulla)
Kluver-Bucy syndrome is caused by a lesion of the ____
bilateral amygdalas
step-wise decline in cognitive ability with late-onset memory impairment.
vascular dementia
Triad of urinary incontinence, gait apraxia (magnetic gait), and cognitive dysfunction
Normal pressure hydrocephalus
Eyes look toward side of hemiplegia
Lesion of the Paramedian Pontine Reticular formation
Stroke of the ___ artery at the _____ causes:
Dysphagia, hoarseness, decreased gag reflex, hiccups
Posterior Inferior Cerebellar A.
Nucleus Ambiguus (CN IX, X, XI) (Lateral Medulla)
(specific to PICA)
inability to look toward the side of lesion
ipsilateral gaze palsy
Hypertensive hemorrhages (Charcot-Bouchard microaneurysms) most often occur in ______, followed by thalamus, pons, and cerebellum.
putamen of basal ganglia (lenticulostriate vessels)
Locked-in syndrome is caused by disruption of the ___ artery
Basilar
pons, medulla, lower midbrain
A stroke of the ____ artery causes contralateral paralysis. Absence of cortical signs (eg neglect, aphasia, visual field loss)
lenticulostriate
Presents in a premature/low-birth-weight infant as altered level of consciousness, bulging fontanelle, hypotension, seizures, coma. Bleeding into ventricles.
Neonatal intraventricular hemorrhage
Called Lewy body dementia if cognitive and motor sx onset is less than ____ apart, otherwise considered dementia secondary to Parkinson disease
< 1 year
Reduced levels of arousal and wakefulness (eg, coma) is caused by a lesion of the ____ in the ____
Reticular activating system
midbrain
Neonatal intraventricular hemorrhage originates in the germinal matrix and is due to _______ and _______ in premature infants.
reduced glial fiber support
impaired autoregulation of BP
___ herniation can compress the anterior cerebral artery
Cingulate (subfalcine)
- under the falx cerebri
Uncus = median ___ lobe
temporal
Stroke of the ___ artery at the _____ causes:
Ipsilateral Horner syndrome
Posterior Inferior Cerebellar A. sympathetic fibers (Lateral Medulla)
Stroke of the ___ artery at the _____ causes:
Vomiting, vertigo, nystagmus
Posterior Inferior Cerebellar A. Vestibular nuclei (Lateral Medulla)
____ posturing is caused by a lesion AT OR BELOW the red nucleus (of the midbrain)
Decerebrate (extensor)
- extension of upper and lower extremities
Disinhibition and deficits in concentration, orientation, judgment; may have reemergence of primitive reflexes.
Frontal Lobe lesion
Symptoms of ACom compression?
bitemporal hemianopsia (compression of optic chiasm); visual acuity deficits
Symptoms of PCom compression?
ipsilateral CN III palsy –> mydriasis (“blown pupil”), may also have ptosis, “down and out” eye
___ herniation can compress CN III, Posterior Cerebral A., and the paramedian A (Duret hemorrhages), leading to an ipsilateral blown pupil with contralateral hemiparesis
uncal transtentorial
contralateral hemiballismus
lesion of subthalamic nucleus
Stroke of the ___ artery at the _____ causes:
Paralysis of face (LMN), decreased lacrimation, decreased salivation, decreased taste from anterior 2/3 of tongue
Anterior Inferior Cerebellar A. Facial nucleus (Lateral Medulla)
Which type of posturing has a worse prognosis?
Decerebrate posturing
Lateral Pontine syndrome is caused by disruption of the ___ artery
AICA
lesion causes Intention tremor, limb ataxia, loss of balance
cerebellar hemisphere lesion (ipsilateral deficits; fall towards side of lesion)
Hemiballismus is caused by a lesion of the ____
Contralateral subthalamic nucleus (lacunar stroke)
Stroke of the ___ artery causes:
Quadriplegia and loss of horizontal (but not vertical eye movements)
RAS is spared = preserved consciousness
Basilar
Stroke of the ___ artery causes:
Contralateral paralysis. Absence of cortical signs (eg, neglect, aphasia, visual field loss)
Lenticulostriate
Lesion of ___ causes internuclear opthalmoplegia
Medial Longitudinal fasciculus
Stroke of the ___ artery at the _____ causes:
Anterior Inferior Cerebellar A. Sympathetic fibers (Lateral pons)
Guillain barre syndrome is also known as what?
Acute inflammatory demyelinating polyradiculopathy
Stroke of the ___ artery at the _____ causes:
Anterior Inferior Cerebellar A.
Middle and Inferior Cerebellar Peduncles (Lateral pons)
____ posturing is caused by a lesion ABOVE the red nucleus (of the midbrain)
Decorticate (flexor)
- flexion of upper extremities, extension of lower extremities
Agraphia, acalculia, finger agnosia, left-right disorientation
Lesion of Dominant parietal cortex
aka Gertmann syndrome
Symptoms of MCA rupture?
contralateral upper extremity and lower facial hemiparesis, sensory deficits
Intention tremor is caused by a lesion of the ____;
Resting tremor is caused by a lesion of the ____.
Cerebellar dysfunction;
Substantia nigra
disinhibited behavior (eg, hyperphagia, hypersexuality, hyperorality)
Kluver-Bucy syndrome
Medial Medullary syndrome is caused by an infarct of the ______ and/or _____
paramedian branches of ASA
vertebral arteries
___ herniation can lead to coma and death due to brainstem compression
Cerebellar tonsillar
- into the foramen magnum
___ herniation can cause caudal displacement of the brain stem, leading to rupture of paramedian basilar artery branches –> Duret hemorrhages (usually fatal)
Central/ downward transtentorial
Lesion of the ___ causes truncal ataxia (wide-based, “drunken sailor” gait), nystagmus
cerebellar vermis
- associated with chronic alcohol abuse
Destructive lesion such as an MCA stroke: eyes look towards the side of the lesion (or at the hemiplegia). Irritative lesion such as seizures: eyes look at the shaking arm and leg.
Frontal eye field lesion
Anterograde amnesia – inability to make new memories
Hippocampus (bilateral lesions)
Wernicke-Korsakoff syndrome is caused by a lesion of the ______
bilateral Mammillary bodie
Stroke of the ___ artery causes:
Contralateral paralysis–upper and lower limbs.
Decreased proprioception
Ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally)
Anterior Spinal Artery (aka Medial Medullary Syndrome)
Symptoms of ACom rupture?
contralateral lower extremity hemiparesis, sensory dificits
vertical gaze palsy, pupillary light-near dissociation, lid retraction, convergence-retraction nystagmus
Parinaud syndrome
Lateral medullary (Wallenberg) syndrome is caused by disruption of the ___ artery
PICA
Stroke of the ___ artery causes:
Contralateral paralysis and sensory loss–lower limb, urinary incontinence.
Anterior Cerebral Artery
