stroke

Question 1

spinothalamic tract presentation

Answer 1

contralateral loss of pain and temperature sensation

Question 2

spinal trigeminal nucleus stroke presentation

Answer 2

ipsilateral facial loss of pain and temperature

Question 3

nucleus ambiguus stroke presentation

Answer 3

supplies the vagus and glossopharyngeal nerves: dysphagia, dystonia, diminished gag reflux

Question 4

inferior vesitibular nucleus stroke presentation

Answer 4

vertigo, diplopia, nystagmus, vomiting

Question 5

sympathetic tract stroke presentation

Answer 5

ipsilateral horners

Question 6

central trigeminal tract stroke presentation

Answer 6

palatal clonus

Question 7

inferior cerebellar peduncle stroke presentation

Answer 7

ataxia

Question 8

Unilateral posterior cerebral artery (occipital lobe stroke)

Answer 8

contralateral homonymous hemianopsia with macular sparing

Question 9

Unilateral PCA stroke (dominant occipital plus splenum of corpus stroke presentation)

Answer 9

homonymous hemianopsia and Alexia (ability to read) without agraphia (loss of ability to write)

Question 10

Unilateral PCA stroke (infracalcine or vental occipital cortex)

Answer 10

achromatopsia –loss of color differentiation contralateral to the side of the lesion. can also be associated with quadrantanopsia (loss of a quadrant of visual field).

Question 11

Unilateral PCA stroke (optic radiation or suprafalcine

Answer 11

inferior quadrantanopsia

Question 12

Unilateral PCA Stroke (Meyer’s loop or infracalcine)

Answer 12

superior quandrantonopsia

Question 13

bilateral PCA stroke

Answer 13

Cortical blindness –bilateral with normal ophthalmological findings.
Anton’s syndrome: cortical blindness with denial of blindness and confabulations or visual hallucinations

Question 14

Posterior inferior cerebellar artery stroke (PICA) inferior posterior cerebellar hemisphere, inferior vermis, lateral medulla

Answer 14

presents with lateral medullary syndrome (Wallenberg syndrome) Or superior cerebellar artery syndrome –vertigo, nausea, vomiting, ipsilateral facial numbness and dysmetria, Horner’s syndrome, dysphagia, and ataxia dysphonia contralateral hemisensory loss below the face.

Question 15

SCA superior cerebellar artery stroke (dorsolateral upper brainstem and cerebellum and superior cerebellar peduncle)

Answer 15

superior cerebellar artery syndrome –ispsalateral limb ataxia, vertigo, nystagmus, dysarthria and gait ataxia

Question 16

AICA anterior inferior cerebellar artery stroke (ipsilateral labyrinth, lateral pontine tegmentum, and brachium pontis, ICP)

Answer 16

lateral pontine syndrome –ipsalateral dysmetria, hearing loss, horner’s syndrome, choreaform dyskinesia, contralateral thermoanalgesia.

Question 17

top of the basilar artery stroke (midbrain, thalamus, and mesial temporal lobes an occipital lobes).

Answer 17

top of the basilar syndrome –somnolene, pedunclar hallucinations, convergence nystagmus, skew deviation, oscillatory ye movements, colliers sign (retraction and elevation of the eyelids) vertical gaze paralysis.

Question 18

mid-basilar stroke (lateral and medial pons)

Answer 18

lateral mid pontine syndrome –ipsalateral loss of facial sensation and motors function of the trigeminal nerve, ipsilateral dysmetria.
medial mid-pontine syndrome –ipsilateral dysmetria, contralateral arm and leg weakness, and gaze deviation.

Question 19

pontine paramedian penetrators (anteromedial pons_

Answer 19

Dorsal-mid-pontine syndrome: ipsilateral nuclear facial palsy, horizontal gaze palsy, and contralateral area nd leg weakness

Question 20

short pontine circumferential arteries (anterolateral pons)

Answer 20

superior medial pontine syndrome –intralateral intranuclear ophthalmoplegia, palatal, facial pharyngeal and or ocular myoclonus, dysmetria, and contralateral arm and leg weakness with ocular bobbing

Question 21

proximal basilar stroke (lower pons)

Answer 21

locked-in syndrome –quadriplegia, horizontal gaze paralysis, bifacial paralysis, tongue and mandibular weakness, awareness is spared.

Question 22

vertebral artery stroke (medulla and cervical spinal cord)

Answer 22

medial medullary or Dejerine syndrome –contralateral arm and leg weakness, homebody loss of tactile vibration, position sense, ipsilateral tongue paralysis.

Question 23

anterior spinal artery stroke

Answer 23

anterior spinal artery syndrome –quadriparesis, bilateral pain and temperature loss. decreased sphincter tone, autonomic instability and hyperreflexia. proprioception spared.

Question 24

Anterior communicating artery

Answer 24

common site of berry aneurysm compression of cranial nerves. causes visual field deficits.

Question 25

posterior communicating arteries

Answer 25

common site of berry aneurysm that causes CN III palsy, eyes go down and out. ptosis and pupil dilation.