Neurology - Strokes/neuroanat

Question 1

What is foster Kennedy syndrome?

Answer 1

A syndrome causing anosmia, optic nerve compression, gait apraxia (muscles intact but unable to coordinate muscles). Can be caused by meningioma/lesion.

Question 2

What are the cortical signs for frontal lobe?

Answer 2

• primary motor cortex
• personality
• primitive reflexes
• expressive dysphasia (broca)
• anosmia
• optic nerve compression
• gait apraxia

Question 3

What are the cortical signs for parietal lobe?

Answer 3

• primary sensory cortex
• grestmann syndrome - lesion in dominant lobe/angular gyrus - causes acalculia, agraphia, left right disorientation, finger agnosia.
• sensory, visual and spatial inattention
• construction and dressing apraxia
• lower quadrantanopia.

Question 4

What are the cortical signs for occipital lobe?

Answer 4

• Homononymous hemianopia.
• Anton’s syndrome (cortical blindness with confabulation)
• alexia (unable to read) but without agraphia

Question 5

Thalamus rules of 4 and arterial supply

Answer 5

Terminal for all sensory nerves.
Arterial supply from PCA.
Anterior nuclei involved with language and memory function.
Lateral nuclei involved with motor and sensory function
Medial nuclei important for maintaining arousal and memory.
Posterior nuclei involved with visual function.

Question 6

What are the rules of 4 for brainstem?

Answer 6

1. There are 4 cranial nerves in the medulla, 4 in the pons and 4 above the pons (1+2 in the brain, 3 and 4 in the midbrain)
2. There are 4 structures in the midline beginning with M
3. There are 4 structures to the side beginning with S
4. 4 motor nuclei in the midline that divide equally into 12 (3,4,6,12)

The 4 medial structures are:

1. Motor pathway (corticospinal tract, corona radiate; internal calsule)
2. Medial Lemniscus - dorsal column
3. Medial longitudinal fasciculus ( connects 3 and 6)
4. Motor nucleus (3,4,6,12)

The 4 side structures are:

1. Spinocerebellar
2. Spinothalamic
3. Sensory nucleus of the 5th CN
4. Sympathetic tract

Question 7

What are the diagnostic criteria/clinical symptoms of cjd?

Answer 7

2 out of 4
1. Myoclonus
2. Visual or cerebellar disturbance
3. Pyramidal or extrapyramidal dysfunction
4. Akinetic mutism