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Neuro > Presentation / Anatomy of Stroke > Flashcards

Presentation / Anatomy of Stroke Flashcards

1
Q

What are symptoms if parietal lobe

A 
Hemisensory loss 
Sensory inattention 
Apraxia
Agnosia 
Tactile agnosia - decreased 2 point discrimination
Inferior homonymous quadrantopia
Gerstmann's
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2
Q

What is Gerstmann’s syndrome

A 
Lesion in dominant parietal lobe
R-L disorientation 
Finger agnosia 
Alcalculia (inability to do maths) 
Agrapghia
Alexia (inability to understand words)
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3
Q

What are symptoms of occipital lobe lesion

A

Contralateral homonymous hemianopia
Cortical blindness
Visual agnosia

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4
Q

What are symptoms of temporal lobe lesion

A

Weirnecke’s aphasia/ dysphasia = same thin
Superior homonymous quadranopia / hemianopia on same side
Auditory agnosia
Amnesia
Prosopagnosia

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5
Q

What are symptoms of frontal lobe lesion

A 
Hemparesis
Broca's aphasia
Executive dysfunction 
Personality change / disinhibition 
Memory loss 
Anosmia 
Agnosia
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6
Q

What are symptoms of cerebellar disorder

A 
DANISH P
Gait ataxia
Inattention tremor
Past pointing
Dysdiokinesis
Nystagmus - vertical

If hemisphere = peripheral e.g. finger nose ataxia
If vermis = gait ataxia

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7
Q

Lesion in medial thalamus / mammory bodies

A

Weirnecke’s encephalopathy

Korsakoff

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8
Q

Lesion in SN of basal ganglia

A

Parkinson’s

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9
Q

Lesion in striatum of basal ganglia

A

Huntington’s

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10
Q

Lesion in amygdala

A

Hypersexual
Hyperphagia
Visual agnosia

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11
Q

What does ACA supply

A

Frontal lobe

Motor / vision

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12
Q

What does lesion in ACA cause

A

Contralateral paralysis / hemiparesis LL > UL
Contralateral sensory loss
Gait impaiment
Impairment to logical thought and personality

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13
Q

What does MCA supply

A

Frontal, temporal and parietal lobe

Broca and Wiernecke’s

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14
Q

What can lesion in MCA cause

A

Contralateral hemiparesis - upper L worse than L
Contralateral sensory loss
Contralateral homonymous hemianopia
Gaze paralysis to side of stoke
Aphasia if dominant side - expressive or receptive
Unilateral neglect / ag

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15
Q

What do you get if on dominant side

A

APHASIA

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16
Q

What do you get if on non-dominant side

A

Neglect

Agnosia - can’t interpret sensation

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17
Q

What does lacunar / lentriculostrial artery supply

A

Basal ganglia

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18
Q

What can lesion here cause

A

Pure motor signs - isolated hemiparesis (internal capsule)
Pure sensory signs - isolated hemisensory (thalamus)
Mixed
Ataixa hemiparesis
Dysarthria - motor speech

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19
Q

What do basal ganglia lesions / lacunar not have

A

Cortical Sx

  • Neglect / agnosia
  • Dysphasia
  • Cognition
  • Visual field
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20
Q

What is a stroke RF for basal ganglia stroke

A

Hypertension

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21
Q

What does a basilar artery stroke affect and cause

A

Locked in syndrome as brain stem affected

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22
Q

What does PCA supply

A

Brain stem

Cerebellum

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23
Q

What does PCA stroke cause

A 
Hemiparesis and sensory loss as tracts go through brain stem 
Quadraplegia 
Contralateral homonymous hemianopia
Macular sparing
Visual agnosia
CN palsy
Locked in
Ataxia / vertigo / coma
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24
Q

What does retinal artery stroke cause

A

Sudden loss of vision

Amaurosis fugax

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25
Q

What does cerebellar stroke cause

A

Ataxia
Vertigo
Incoordination
Vertical nystagmus

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26
Q

`What is Weber syndrome

A

Branches of MCA or PCA that supply midbrain of brain stem
Midbrain infarction
Takes out SN / corticospinal / corticobulbar and 3rd CN tract

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27
Q

What do you get if Weber syndrome

A

Ipsilateral CN III palsy

Contralateral weakness of UL and LL

28
Q

What is the posterior inferior cerebellar artery syndrome called if infarct

A

Lateral medullary / Wallenberg

29
Q

What does it cause

A 
Contralateral limb pain and temp loss - spinothalamic 
Ipsilateral face pain and temp loss - CN5 
Ipsilateral Ataxia - CN8 
Ipsilateral Nystagmus - CN8
Ipsilateral Vertigo - CN8 
Vomiting 
Ipsilateral horners 
CN palsy 9/10 
- Dysphagia
- Dysarthria
- Decreased gag reflex
30
Q

What is the anterior inferior cerebellar artery syndrome called

A

Lateral pontine

31
Q

What does it cause

A

Similar to Lateral medulla

BUT ipsilateral facial paralysis and deafness

32
Q

How does haemorrhagic stroke present

A 
Deceased GCS
Headache
N+V
Seizure
Stiff neck
Photophobia
33
Q

What is aphasia

A

Impairment of language affecting production or comprehension of speech and ability to read or write

34
Q

What is receptive aphasia

A

Difficulty understanding spoken or written language

35
Q

What is expressive aphasia

A

Partial loss of ability to produce language (spoken, manual or written)

36
Q

What is Wernicke’s

A

Receptive aphasia

37
Q

What causes Wernicke’s

A

Lesion in superior temporal gyrus of temporal lobe

38
Q

What artery supplies

39
Q

What does Wiernecke’s area do

A

Forms speech before sending it to Broca’s area

40
Q

What does it result in

A

Sentences that make no sense
Word neologism + substitution
Still fluent but impaired comprehension

41
Q

What is Broca’s

A

Expressive aphasia

42
Q

What causes

A

Lesion in inferior frontal gyrus of frontal lobe

43
Q

What artery supplies

44
Q

What does it result in

A

Non-fluent speech
Laboured and haunting
Comprehension normal

45
Q

What is a conduction stroke

A

Stroke affecting area between Wernicke’s and Broca - the arcuate fasiculus

46
Q

What does it result in

A

Fluent speech
Poor repetition
Aware of error
Comprehension normal

47
Q

What is a global aphasia stroke

A

Large lesion affecting all 3 ares

Severe expressive and receptive aphasia

48
Q

TERMS

49
Q

What can cause cerebellar syndrome

A 
PASTRIES
Posterior tumour (cerebellar haemangioma) / lung cancer
Alcohol 
MS
Trauma
Rare
Inherited - Fredirech
Epileptic meds - phenytoin 
Stroke
50
Q

What is mnemonic to remember symptoms

A

DANISHP

  • Dysdiodochokinesia - no rapid movement
  • Ataxia
  • Nystagmus - towards side of lesion
  • Inattention tremur
  • Scanning dysarthria / slurred staccato speech (jerky, explosive, slurred and loud due to ataxia of larynx)
  • Hypotonia
  • Past pointing
51
Q

What does ataxia lead too

A

Wide based gait
Loss of heel toe
Instable

52
Q

What is the nystagmus

A

Ipsilateral
Vertical if central cause
Horizontal if peripheral cause

53
Q

N

A

Nystagmus

Ipislateral

54
Q

See obtunded patient for normal functions

55
Q

What is dysarthria

A

Motor speech disorder
Unclear articulation
Logistics = normal

56
Q

What is ataxia

A

Cerebellar lesion affecting coordination and balance

57
Q

What is agnosia

A

Inability to interpret sensation or recognise things
Different types
Form of neglect

58
Q

What are different types

A 
Visual
Sensory
Prosopagnosia (can't recognise facE) 
Asteroagnosia (can't interpret by touch) 
Anasagnosia (denial of hemiplegia)
59
Q

What is neglect

A

Deficit to awareness and attention to one side of field of vision

60
Q

What is anosmia

A

Inabiity to smell

61
Q

What is apraxia

A

Inability to carry out skilled motor tasks

62
Q

What is ideomotor apraxia

A

Inability to know how or what to do with skilled motor tasks

63
Q

What is agrpahia

A

Impairment of writing

64
Q

What is alcalcui

A

Inability to do simple maths (parietal)

65
Q

What is alexia

A

Inability to read or write

66
Q

What causes unilateral signs cerebellar

A

MS
Vascular
SOL

67
Q

What causes bilateral signs cerebellar

A

All unilateral
Inherited
Metabolic
Medication - phenytoin

Neuro (19 decks)

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