Stroke Flashcards
UMN type symptoms
Weakness
Increased tone
Increased reflex
LMN symptoms
Weakness Decreased tone Decreased reflex Atrophy Fasciculation
Left ACA infarct symptoms
Weakness of the UMN type in the right leg, cortical sensory loss in the right leg, frontal lobe behavioral abnormalities, abulia, grasp reflex, and transcortical aphasia (larger infarcts can cause hemiplegia)
Abulia
Inability to act decisively or lack of will power
Alien hand
Due to supplementary motor damage
Right ACA infarct symptoms
Weakness of the UMN in the left leg, cortical sensory loss of the left leg, hemineglect, grasp reflex, and frontal lobe behavioral abnormalities (larger infarcts can cause hemiplegia of the left side)
Left PCA Infarct
Right homonymous hemianopia, if extends to the selenium of the corpus callosum will have alexia without agraphia, if extends to thalamus and internal capsule can have aphasia, right hemisensory loss, and right hemiplegia
Right PCA infarct
Left homonymous hemianopia, larger infarcts that involve the thalamus and internal capsule can cause left hemisensory loss and left hemineglect
Divisions of MCA
Superior, inferior, deep territories, and stem
Left MCA superior division symptoms
Weakness of the UMN type in the face and arm, non-fluent or Broca’s aphasia, and cortical sensory loss in the face and arm
Left MCA inferior division
Fluent or wernicke’s aphasia, visual field cut, sensory loss in the face and arm, motor symptoms are usually absent but you can see mild right-sided weakness in the face and arm especially at the onset
Left MCA deep territory
Right pure motor hemispheres is of the UMN type - larger infarcts may produce cortical deficits, such as aphasia
Left MCA Stem
Global aphasia, weakness in the right face and arm of UMN type, sensory loss in the right face and arm, right homonymous hemianopia, right hemiplegia, right hemianesthesia, and a left gaze preference (especially at the onset) caused by damage to the left hemisphere cortical areas important for driving the eyes to the right
Right MCA superior division
Weakness of the left face and arm of UMN type, sensory loss in left face and arm, and hemineglect is present to a variable degree
Right MCA inferior division symptoms
Profound hemineglect, motor neglect with decreased voluntary or spontaneous initiation of movement of the left side (you can see some spontaneous movements and withdrawal from pain), somatosensory deficits, left visual field cut, you may see mild weakness of the left, and there is often a right gaze preference especially at the onset
Watershed zones
Regions between cerebral arteries - ACA-MCA and MCA-PCA watershed zones - blood supply to two adjacent cerebral arteries are compromised
Watershed infarct symptoms
Can cause proximal arm and leg weakness (“man in the barrel” syndrome) because the regions of the homunculus involve the trunk and proximal limbs
Dominant can see transcortical aphasia
MCA-PCA can disturb higher-order visual processing
Right MCA deep territory symptoms
Left pure motor hemiparesis of the UMN type - larger infarcts may produce “cortical” deficits, such as left hemineglect
Right MCA stem symptoms
Profound left hemineglect, weakness of the UMN type of the left face and arm, somatosensory deficits, motor neglect of the left side, left hemiplegia, left hemianesthesia, left homonymous hemianopia, and right gaze preference especially at the onset
What connects the ACA and MCA
Anterior communicating artery
What symptoms suggest hemispheric damage?
Aphasia, visual field cuts, hemineglect, and sensory-motor deficits
What symptoms suggest vertebrobasilar territory damage
Ataxia, vertigo, nausea, and vomiting
Describe the function of the brain in terms of oxygen, glucose, etc.
The brain accounts for 2% of body weight but uses 20% of cardiac output and 25% of resting total body oxygen consumption
Does not store nutrients, so requires an uninterrupted supply of oxygen and glucose (simple sugar - energy source)
What is the stages of infarction
Limited auto regulation, critical perfusion, ischemia, and infarction
