Neuro Strokes And Tracts

Question 1

What occurs with MCA stroke

Answer 1

Contralateral hemiplegia with Motor/sensory deficits in the face and UE > LE

Contralateral homonymous hemianopsia

Dominant L hemisphere= aphasia
R hemisphere= perceptual deficits

Question 2

What occurs with ACA stroke?

Answer 2

Contralateral hemiplegia with motor and sensory losses > in LE than UE.
Apraxia
Akinetic mutism
Urinary incontinence

Mental impairments: confusion, amnesia, apathy, short attention
span

Question 3

What occurs with PCA stroke?

Answer 3

Contralateral sensory loss
Transient contralateral hemiparesis (if cerebral peduncle involved)
Visual deficits: homonymous hemianopsia, visual agnosia
Aphasia and thalami pain syndrome can result

Question 4

Internal capsule posterior limb stroke or Lacunar stroke

Answer 4

Pure motor

Contralateral hemiplegia UE and LE

Question 5

Midbrain stroke

Answer 5

Contralateral hemiplegia

CN III palsy

Question 6

Medial inferior pontine syndrome

Answer 6

Vertigo
Ataxia
Nystagmus
Ipsilateral loss of conjugal gaze 
Diplopia 
Contralateral Hemiparesis UE/LE
Contralateral sensory loss

Question 7

Lateral Pontine syndrome

Answer 7

Vertigo
Ataxia
Nystagmus
Ipsilateral loss of conjugate gaze
Tinnitus
Deafness
Facial paralysis/sensation loss

Contralateral loss of pain and temp to body

Question 8

Medial medullary syndrome

Answer 8

Paralysis of ipsilateral side of tongue

Contralateral hemiplegia to UE/LE and sensory loss

Question 9

Lateral medullary syndrome (wallenbergs syndrome)

Answer 9

Vertigo
Ataxia
Nystagmus

Ipsilateral loss of pain and temp to face

Contralateral loss of sensation to body

Question 10

Anterior inferior cerebellar

Answer 10

Unilateral deafness 
Paresis of lateral gaze 
Vertigo, ataxia, Nystagmus
Contralateral loss of pain and temp 
Unilateral Horner’s syndrome

Question 11

Superior cerebellar

Answer 11

Severe ataxia
Dysmetria
Dysarthria
Contralateral loss of pain and temperature

Question 12

Posterior inferior cerebellar

Answer 12

Wallenbergs syndrome

Horner’s syndrome

Question 13

Dorsal column medial lemniscal system

Answer 13

Proprioception, vibration, tactile discrimination, light touch

Cuneate UE (lateral)
Gracile LE (medial)

Question 14

Spinothalamic tract

Answer 14

Pain and temperaturee

Question 15

Spinocerebellar Tract

Answer 15

Muscle spindles, GTOS to cerebellum for voluntary movement

Question 16

Spinoreticular

Answer 16

Convey deep and chronic pain

Question 17

What’s an easy trick to remember the ascending (sensory pathways)

Answer 17

Ascending pathways start with SPINAL except for DCML

Question 18

What’s an easy way to remember descending pathways?

Answer 18

Descending pathways end in spinal because they start from the brain and go to the spine to the body.

Question 19

Function of corticospinal tracts? Where do they decussate?

Answer 19

Voluntary motor control

Decussate in the medulla in the pyramids.

Question 20

Vestibulospinal tract function

Answer 20

Muscle tone
Antigravity muscles
postural reflexes

Question 21

Rubrospinal tract function

Answer 21

Coordination

Assist with motor function

Question 22

Function of the tectospinal tract

Answer 22

Head turning response to stimuli