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neurology > Pathology I > Flashcards

Pathology I Flashcards

1
Q

effects of lesion in frontal lobe

A

Disinhibition and problems with concentration, judgement

Reemergence of primitive reflexes

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2
Q

effects of lesion in frontal eye fields

A

If its a destructive lesions such as MCA stroke - eyes look towards side of lesion

If its an irritive lesion such as seizure - eyes look towards shaking limb

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3
Q

effects of lesion in paramedian pontine reticular formation

A

ipsilateral gaze palsy (cannot look toward the side of the lesion)

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4
Q

What is the paramedian pontine reticular formation

A

Brain region in the pons that coordinates eye movements - especially horizontal gaze/saccades

Coordinates the eyes looking in the same direction

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5
Q

What is the medial longitudinal fasciculus?

A

Links the nerves that control eye movements (CN III, CN IV, CN VI) and integrates eye movements with head movements

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6
Q

Findings with a lesion in the medial longitudinal fasciculus

A

Impaired adduction of eye on ipsilateral side and nystagmus of eye on contralateral side with abduction

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7
Q

effects of lesion in dominant parietal cortex

A

Agraphia, acalculia, finger agnosia, left-right disorientation (confusion of left and right limbs)

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8
Q

effects of lesion in nondominant parietal cortex

A

agnosia of the contralateral side of the world

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9
Q

a lesion in the dominant parietal cortex results in which syndrome?

A

Gestmann syndrome

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10
Q

a lesion in the nondominant parietal cortex results in which syndrome?

A

hemispatial neglect syndrome

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11
Q

effects of lesion in hippocampus (bilateral)

A

anteriograde amnesia

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12
Q

effects of lesion in basal ganglia

A

can result in tremor at rest, chorea, athetosis

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13
Q

effects of lesion in subthalamic nucleus

A

contralateral hemiballismus

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14
Q

effects of lesion in mammillary bodies

A

memory loss

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15
Q

An example of a lesion to the mammilary bodies is seen in which syndrome?

A

Wernicke-Korsakoff

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16
Q

Wernicke-korsakoffe presentation

A

confusion, ataxia, nystagmus, opthalmoplegia, memory loss, confabulation, personality changes

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17
Q

effects of lesion in amygdala (bilateral)

A

Results in Kluver-Busy syndrome - disinhibited behaviour - hyperphagia, hypersexuality, hyperorality

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18
Q

Viral cause of Kluver-Busy syndrome?

A

HSV-1 encephalitis

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19
Q

Lesion in dorsal midbrain causes which syndrome?

A

Parinaud syndrome

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20
Q

Parinaud syndrome presentation

A

vertical gaze palsy, pupillary light-near dissociation, lid retraction, convergence-retraction nystagmus

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21
Q

effects of lesion in reticular activating system

A

reduced levels of arousal and wakefulness (coma)

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22
Q

effects of lesion in cerebellar hemisphere

A

intention tremor, limb ataxia, loss of balance

IPSILATERAL deficits

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23
Q

effects of lesion in red nucleus (midbrain)

A

Decorticate posturing if lesion is above red nucleus

Decerebrate posturing if lesion is at or below red nucleus

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24
Q

effects of lesion in cerebellar vermis

A

truncal ataxia, nystagmus

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25
Q

Chronic alcohol use is associated with a lesion where?

A

cerebellar vermis

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26
Q

Which scan detects ischemic injury within 3-30 min?

A

MRI

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27
Q

Which scan detects ischemic injury within 6-24 hours?

A

CT

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28
Q

Histology of ischemic stroke at 12-24 hours

A

Eosinophilic cytoplasm + pyknotic nuclei (red neurons)

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29
Q

Histology of ischemic stroke at 24-72 hours

A

necrosis + neutrophils

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30
Q

Histology of ischemic stroke at 3-5 days

A

macrophages

31
Q

Histology of ischemic stroke at 1-2 weeks

A

reactive gliosis (astrocytes) + vascular proliferation

32
Q

Histology of ischemic stroke at >2weeks

A

glial scar

33
Q

What is neonatal intravenricular hemorrhage

A

bleeding into the ventricles

34
Q

which babies are at risk for intravenricular hemorrhage

A

premature and low-birth-weight infants

35
Q

Where does the bleeding orginate in neonatal intravenricular hemorrhage?

A

germinal matrix (highly vascularized region within the subventricular zone)

36
Q

how does neonatal intravenricular hemorrhage present?

A

altered consciousness, buldging fontanelle, hypotension, seizures, coma

37
Q

Which artery is rupted in a epidural hematoma?

A

middle meningeal

38
Q

presentation of epidural hematoma

A

loss of consciousness -> recovery (lucid interval) -> rapid deterioration due to hematoma expansion

39
Q

what will a CT of an epidural hematoma look like

A

biconvex hyperdense blood collection that does not cross suture lines

40
Q

What ruptures in a subdural hematoma?

A

bridging veins (venous bleed)

41
Q

causes of a chronic subdural hematoma?

A

mild trauma, cerebral atrophy, elderly, alcoholism, shaken baby

42
Q

what does a subdural hematoma look like on CT ?

A

crescent-shaped hemorrhage that crosses suture lines. May cause a midline shift.

43
Q

Causes of a subarachnoid hemorhage?

A

bleeding due to trauma, ruupture of an aneurysm, arteriovenous malformation

44
Q

What will be seen on a lumbar puncture of someone with a subarachnoid haemorrhage?

A

bloody or yellow lumbar puncture

45
Q

What is a common complication of someone with a subarachnoid hemorrhage?

A

Vasospasm or rebleed 3-10 days laters

Increased risk of communicating/obstructive hydrocephalus

46
Q

How to prevent vasopspasm/rebleed in a patient who has had a subarachnoid hemorrhage?

A

nimodipine

47
Q

What is the most common cause of an intraparenchymal haemorrhage?

A

systemic hypertension

48
Q

What is amyloid angiopathy associated with?

A

Intraparenchymal hemorrhage

49
Q

Where do intraparynchemal hemorrhages commonly occur?

A

putamen/internal capsule

50
Q

Complication of intraparenchymal hemorrhage

A

Contralateral hemiparesis and hemisensory loss

51
Q

Which areas of the brain may be effected with a MCA stroke?

A 
motor and sensory cortexes --- upper limb and face
Temporal lobe (wernickes), frontal lobe (brocas)
52
Q

What areas of the brain may be effected with a ACA stroke?

A

motor and sensory cortexes of the lower limb

53
Q

Which areas may be effected with a stroek in the lenticulostriate-artery?

A

striatum, internal capsule

54
Q

How will a patient who has had a stroke in the lenticulostriate artery present?

A

Contralateral paralysis without cortical signs (aphasia, visual loss, etc).

55
Q

presentatin of a patient who has had a MCA stroke?

A

contralateral paralysis and sensory loss —- face and upper limb
If in dominant hemisphere -aphasia
If in nondominant hemisphere - hemineglect

56
Q

Which areas will be affected in a patient with an anterior spinal artery stroke?

A

Lateral corticospinal tract

Medial lemniscus

caudal medulla (hypoglossal nerve)

57
Q

Medial medullary syndrome cause

A

infarct of the paramedian branches of the ASA and or vertebral arteries

58
Q

areas effected in someone with a posterior inferior cerebellar artery stroke

A

Lateral medulla (nucleus ambiguus CN IX, X, XI)
Vestibular nuclei
Lateral spinothalamic tract, spinal trigeminal nucleus
Sympathetic fibers
Inferior cerebellar peduncle

59
Q

Presentation of someone with an ASA stroke

A

Tongue deviated towards side of lesion (ipsilateral)
Contralateral paralysis of upper and lower limbs
Decreased contralateral proprioception

60
Q

Presentation of someone with a PICA stroke

A

Dysphagia, hoarseness, decreased gag reflex, hiccups

Vomiting, vertigo, nystagmus
Decreased pain and temp sensation from contrateral body and ipsilateral face
Ipsilateral horner syndrome, ipsilateral ataxia

61
Q

What is the name of the syndrome seen in someone with a PICA stroke?

A

Lateral medullary (Wallenburg) syndrome

62
Q

Areas effected in someone with an AICA stroke

A

Lateral pons (facial nucleus)

Vestibular nuclei
Spinothalamic tract, spinal trigeminal nucleus

Sympathetic fibers,
middle and inferior cerebellar peduncles

Labyrinthe artery

63
Q

Presentation of someone with an AICA stroke?

A

paralysis of the face - decreased lacrimation, decreased salivation, decreased taste from anterior tongue

vomiting, vertigo, nystagmus, decreased pain and temp sensation from controlateral body and ipsilateral face

Ipsilateral horner syndrome
Ipsilateral ataxia, dysmetric

Ipsilateral sensorineural deafness/vertigo

64
Q

What is the name of the syndrome seen in someone with an AICA stroke?

A

Lateral pontine syndrome

65
Q

Areas effected in someone with a basilar artery stroke?

A

pons, medulla, lower midbrain
Corticopsinal and corticobulbar tracts
Ocular cranial nerve nuclei, paramedian pontine reticular formation

66
Q

Presentation of someone with a basilar artery stroke?

A

RAS spared so there is preserved consciousness

Quadriplegia: loss of voluntary facial mouth and tongue movements

Loss of horizontal but not verticle eye movements

67
Q

What is the name of the syndrome seen in someone who has had a basilar artery stroke?

A

Locked in syndrome

68
Q

What area is affected in someone who has had a posterior cerebral artery stroke?

A

occipital lobe

69
Q

Presentation of someone who has had a PCA stroke?

A

contralateral hemianopia with macular sparing

Alexia without agraphia

70
Q

What is central poststroke pain syndrome?

A

neuropathic pain due to thalamic lesoins
Initial parasthesias followed by allodynia
(10% of stroke patients)

71
Q

What causes diffuse axonal injury?

A

traumatic shearing forces during rapid acceleration/decceleration

72
Q

Presentation of patient with diffuse axonal injury

A

coma or persistant vegetative state

73
Q

MRI findings of patient with diffuse axonal injury

A

multiple lesions (punctate hemorrhages) involving the white matter tracts

neurology (9 decks)

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