Neuro Strokes and Lesions

Question 1

Label a diagram of the circle of willis

Answer 1

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Question 2

How does a lesion to middle cerebral artery present?

Answer 2

contralateral PARALYSIS of face and UPPER limb. APHASIA if dominant hemisphere affected. HEMINEGLECT if nondominant

Question 3

How does a lesion to anterior cerebral artery present?

Answer 3

contralateral PARALYSIS of LOWER limb
urinary incontinence
behaviour changes

Question 4

How does a lesion to lenticulostriate artery present? which region of brain does it affect?

Answer 4

contralateral PARALYSIS both UPPER and LOWER limbs + UMN Facial PARALYSIS. affects striatum

Question 5

How does a lesion to the basilar artery present?

Answer 5

Quadriplegia/locked in syndrome
Loss of HORIZONTAL eye movements if Pontine artery occluded (lnternuclear opthalmoplegia)

Question 6

How does a lesion to the posterior cerebral artery present?

Answer 6

contralateral hemianopia with MACULA SPARING. - no paring = lesion to optic tract instead
Webers Syndrome - CN3 palsy (down and out), contralateral PARALYSIS of face and body (UPPER and LOWER limbs)

contralateral hemisensory loss of all modalities - if thalamus affected

Question 7

How does a lesion to Anterior spinal artery (a branch of vertebral artery) present?

Answer 7

Medial medullary syndrome = contralateral PARALYSIS of body (UPPER and LOWER LIMBS) + IPSILATERAL TONGUE DEVIATION
Contralateral loss of VIBRATION/PROPRIOCEPTION = KEY sensory finding

Question 8

How does a lesion to posterior inferior cerebellar artery (a branch of vertebral artery) present?

Answer 8

Lateral Medullary (wallenberg) syndrome - Contralateral loss of pain and temperature in UPPER and LOWER limbs. Ipsilateral loss of this in face (sensory finding). + Ipsilateral horners syndrome.
Dont PICA horse that cant eat = hoarsness, dysphagia, diminished gag reflex

Question 9

How does a lesion to anterior inferior cerebellar artery present?

Answer 9

Lateral pontine syndrome - Contralateral loss of pain and temperature in UPPER and LOWER limbs. Ipsilateral loss of this in face (sensory finding). + Ipsilateral horners syndrome.

Facial droop means AICA’s pooped = paralysis of face (key distinguishing factor from PICA).

deafness

Question 10

how does a lesion in primary somatosensory cortex present?

Answer 10

Contralateral sensory deficits, variable impact on arms and legs, may have motor weakness

Question 11

how does a lesion to thalamus present? identify thalamus on image

Answer 11

contralateral COMPLETE sensory loss of all modalities

Question 12

How does a lesion to lateral pons or lateral medulla present? identify pons and medulla

Answer 12

results from damage to PICA or AICA - contralateral loss of pain and temperature. other additional findings depend on blood vessel.

Question 13

How does a lesion to Medial medulla present?

Answer 13

findings you see when anterior spinal artery is occluded

Question 14

review stroke images in textbook

Answer 14

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