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Nervous System And Neuropsychiatry > Session 10: Neurotrauma > Flashcards

Session 10: Neurotrauma Flashcards

1
Q

What is a stroke?

A

The damaging or killing of brain cells starved of oxygen as a result of the blood supply to part of the brain being cut off

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2
Q

What is transient ischaemic attack?

A

A stroke that recovers within 24 hours from the onset of symptoms

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3
Q

What is stroke syndrome?

A

Constellation of signs and symptoms produced due to occlusion or damage of an artery supplying part of the brain

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4
Q

What are the 2 main types of Stroke ?

A
  • Ischaemic
  • Haemorrhagic
  • Other 5% such as Dissection, Venous Sinus Thrombosis
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5
Q

What is the region of supply of Anterior Cerebral artery?

A
  • Medial aspect of the frontal and parietal lobe

- Anterior part of Corpus Callosum

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6
Q

What function of the part of the brain supplied by the anterior cerebral artery?

A
  • Lowe limb motor functions
  • Lower limb sensory functions
  • Role in voluntary control of micturition
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7
Q

What is the presentation of a patient with Anterior Cerebral Artery?

A
  • Upper motor neurone signs such as Hypertonic, Hyperreflexia, Clonus (motor)
  • Loss of all sensory modalities in the contralateral lower limb
  • Loss of voluntary control of micturition due to lack of supply to Paracentral Lobules.
  • Split brain syndrome (corpus callosum)
  • Alien hand syndrome which is disagreement between two hemispheres. (Corpus Callosum)
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8
Q

What is the Region of supply of the Middle Cerebral artery?

A
  • Majority of the Hemisphere
  • Basal ganglia
  • Internal Capsule
  • Macular Cortex
  • Lateral aspects of the Hemisphere
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9
Q

What is the function of the part of the brain supplied by the middle cerebral artery?

A
  • Upper limb motor functions
  • Upper limb sensory functions
  • Eye sight
  • Movement
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10
Q

What is a malignant MCA?

A
  • Main trunk occlusion of the middle cerebral artery
  • Causes considerable cerebral oedema
  • May lead to coma/death
  • Decompression semi hectomy to relieve the pressure compression of the brain
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11
Q

What are the signs of a distal middle cerebral artery stroke?

A
  • Contralateral upper limb and face more affected. Flaccid paralysis followed later by spasticity
  • Contralateral loss of all sensory modalities in the upper limb and face
  • May lead to contralateral homonymous superior or inferior quandrantopia
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12
Q

What are the signs of a proximal middle cerebral artery stroke?

A
  • Contralateral upper limb and face more affected than lower limb
  • Flaccid paralysis followed later by spasticity
  • Leg symptoms as the internal capsule is affected
  • Contralateral loss of all sensory modalities in the upper limb and face
  • Contralateral homonymous hemianopia
  • If dominant hemisphere is affected, it causes Global Aphasia (Broca’s and Wernicke’s Aphasia)
  • If non-dominant side (right) affected, it causes semi-spatial neglect, tactile extinction, visual extinction and anosognosia
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13
Q

What is Tactile extinction?

A

Aware of being touched on the contralateral limb but not ipsilateral as well when both are touched

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14
Q

What is anosognosia?

A

Being without disease knowledge.

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15
Q

What is the region of supply of the posterior cerebral artery and its function?

A
  • Occipital lobe

- Functions for the visual cortex

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16
Q

How does a posterior cerebral artery stroke present?

A

-Contralateral homonymous hemianopsia with macular sparing

17
Q

What is the region of supply of the cerebellar artery?

A
  • Pons
  • Cerebellum
  • Brainstem
18
Q

What is the function of the regions supplied by the cerebellar artery?

A
  • Plays a role in coordination, precision, timing of purposeful movement
  • Corticospinal tract runs in the pons
19
Q

What is the presentation of the proximal cerebellar artery occlusion?

A

Brainstem and cerebellar sign.

  • Dysdiachokinesia
  • Ataxia
  • Nystagmus
  • Intention tremor
  • Slurred speech
  • Hypotonia
  • Crossed deficits affect face on ipsilateral and rest of the body on the contralateral. Damage to ascending/descending tracts affects contralateral side of the body. Damage to cranial nerve or their nuclei gives ipsilateral signs
20
Q

What is the region of supply of the Basilar artery and its functions?

A

Brainstem

  • Pons
  • Medulla
  • Midbrain
21
Q

What is the presentation of distal basilar artery strokes?

A
  • Bilateral occipital lobe infarction
  • Bilateral thalamic infarction
  • Bilateral midbrain infarction
22
Q

What is the presentation of proximal basilar artery stroke?

A

-Locked in syndrome

23
Q

What is the region of supply of the lenticulostriate artery and functions of the region?

A
  • Internal capsule

- The posterior limb which carries the descending motor fibres

24
Q

What is the presentation of lenticulostriate artery?

A

Isolated contralateral

  • Paralysis initially flaccid followed by spasticity. Upper motor signs
  • Involving face, upper limb and lower limb
25
Q

What is the region of supply of the thalamoperforatory artery and the function of this region?

A
  • Part of the thalamus is supplied

- Relays sensory information to the post-central gyrus (somatosensory cortex)

26
Q

What is the presentation of the thalamoperforatory artery?

A

-Isolated contralateral sensory loss in all modalities. Involved face, upper limb, and lower limb

27
Q

What are the stroke mimics?

A
  • Hypoglycaemia
  • Epilepsy
  • Migraine
  • Intracranial tumour/infections
28
Q

Where has the clot come from to cause a stroke?

A
  • Carotid Arteries
  • Vertebral/Basilar arteries
  • Atrial Fibrillation
  • Valvular disease/prosthetic valves
  • Vasculitis
  • Sickle cell anaemia
  • Cocaine
  • Septic Emboli
  • Intra-cardiac thrombus
29
Q

What is affected in an anterior cerebral artery stroke?

A
  • Middle Cerebral Artery

- Anterior Cerebral Artery

30
Q

What are the clinical feature of a total anterior circulation syndrome?

A
  • Hemiparesis AND
  • Higher cortical dysfunction AND
  • Homonymous hemianopia
31
Q

What are the clinical features of partial circulation syndrome?

A
  • Isolated higher cortical dysfunction OR

- Any two of hemianopia, higher cortical dysfunction, hemianopia

32
Q

What are clinical features of Posterior Circulation Syndrome?

A

-Isolated hemianopia, Brainstem of Cerebellar syndromes.

Occlusion of vertebral, basilar, cerebellar or PCA vessels

33
Q

What are Lacunar Stroke syndromes?

A
  • Pure Motor Stoke OR
  • Pure Sensory Stroke OR
  • Sensorimotor Stroke OR
  • Ataxic hemianopia OR
  • Clumsy hand-dysarthria
34
Q

What causes Lacunar stroke syndromes?

A

Caused by small penetrating artery occlusion, usually in the lenticulostriate branches of MA or supply to brainstem or deep white matter.

35
Q

What cause Anterior Circulation Syndromes?

A
  • Usually a proximal branch MCA or ICA occlusion for total

- Usually a branch MCA occlusion for partial

36
Q

What causes Posterior Circulation Syndrome

A

-Occlusion of vertebral, basilar, cerebellar or PCA vessels

Nervous System And Neuropsychiatry (20 decks)

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