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08 Neuro > Stroke > Flashcards

Stroke Flashcards

1
Q

features of ica syndrome

A
  • most variable stroke syndrome
  • can cause infarction of 2/3 of the cerebral hemisphere
  • infarction can be bilateral (if from common ica)

combination of aca, acha, and mca syndrome

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2
Q

signs and symptoms for ica syndrome

A 
transient monocular blindness (amaurosis fugax)
contralateral motor and sensory deficits in face, UE, and LE
contralateral visual field deficit (homonymous hemianopia)
aphasia (dom)
perceptual deficits (nondom)
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3
Q

branches of the aca

A 
acomm
recurrent artery of heubner
medial orbitofrontal artery
frontopolar artery
callosomarginal artery
pericallosal artery
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4
Q

manifestations of lesions in recurrent artery of heubner

A

contralateral face and arm weakness without sensory loss

behavioral and cognitive abnormalities (abulia, agitation, neglect, and aphasia)

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5
Q

manifestations of aca infarct

A

weakness of the leg
+/- proximal muscle weakness in the UE
frontal lobe: judgment, insight, affect, abulia
frontal release signs: grasp and suck reflex
urinary incontinence

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6
Q

segments of mca

A

sphenoidal
insular
opercular
cortical

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7
Q

superior portions of mca

A

lateral Orbitofrontal a.
Prerolandic a. (motor)
Rolandic a. (motor and sensory)
Anterior parietal a.

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8
Q

inferior portions of mca

A

Posterior parietal
Angular gyrus
temporo-occipital, Posterior temporal
Anterior temporal

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9
Q

manifestations of mca non-dominant infarct

A 
left hemiparesis
left sensory loss
left homonymous hemianopia
contralateral conjugate paralysis
dysarthria
left hemineglect
anosognosia
constructional apraxia, topographagnosia, dressing apraxia
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10
Q

manifestations of mca dominant infarct

A

right motor loss of face and UE/LE
right sensory loss: all modalities, decreased stereognosis, graphesthesia
right homonymous hemianopia
dysarthria
aphasia, alexia, agraphia, acalculia, apraxia of left limbs

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11
Q

manifestations of superior division infarct

A

contralateral hemiplegia, hemisensory loss, hemianopia, gaze paresis
global aphasia/dysphasia or anosognosia and hemineglect
gerstmann syndrome

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12
Q

manifestations of inferior division infarct

A

hemianopia
wernicke’s aphasia/dysphasia or anosognosia
hemineglect

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13
Q

anterior spinal artery supplies

A

medullary pyramids
paramedian medullary structures
anterior 2/3 of spinal cord

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14
Q

pica supplies

A

inferior surface of cerebellum
dorsolateral surface of medulla oblongata
choroid plexus of 4th ventricle
deep cerebellar nuclei

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15
Q

posterior spinal artery supplies

A

posterior aspect of medulla below obex

posterior column and posterior horns of spinal cord

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16
Q

long circumferential arteries

A

anterior inferior cerebellar a.
auditory a.
superior cerebellar a.

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17
Q

anterior inferior cerebellar a. supplies

A

inferior surface of cerebellum
brachium pontis (middle peduncle)
restiform body (inf. peduncle)
tegmentum of lower pons and upper medulla

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18
Q

auditory a. supplies

A

inner ear and root fibers of facial nerve

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19
Q

superior cerebellar a. supplies

A 
superior of cerebellum
part of dentate nucleus
brachium pontis and conjunctivum
tegmentum of upper pons
inferior colliculus
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20
Q

short circumferential a. supplies

A

pons

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21
Q

symptoms of vertebro-basilar stroke

A
  • motor: contralateral paresis of UE/LE, peripheral facial palsy
  • dysarthria, hoarseness, dysphagia, ipsilateral ataxia
  • cerebellar signs
  • disconjugate eye movements
22
Q

manifestations of stroke in pons

A

locked in syndrome
facial and limb paralysis
(loss of cst + sparing of vertical gaze and consciousness)

23
Q

pca supplies

A

medial of occipital lobe
temporal lobe
caudal parietal lobe
splenium of corpus callosum

24
Q

manifestations of pca infarct in cortical a.

A

homonymous hemianopsia, cortical blindness, severe visual deficits, visual hallucinations, impaired memory

25
Q

manifestations of pca infarct in penetrating a.

A

thalamus: contralateral sensory loss
brainstem: CN palsies, nystagmus, pupillary abnormalities

26
Q

_____ and ___ are damaged in parinaud’s syndrome

A

DORSAL MIDBRAIN

superior colliculus and midbrain tectum

27
Q

____ generates upward gaze

___ maintains upward gaze

A

rostral interstitial nucleus of medial LF (rimlf) = generates
interstitial nucleus of cajal (inc) = maintains

28
Q

manifestations of lesion in posterior comissure

A

damaged pupillary constriction = large pupils

29
Q

findings in parinaud’s syndrome

A

upward gaze paralysis
normal to large pupils with light near dissociation
lid retraction
convergence-retraction nystagmus

30
Q

common causes of parinaud’s syndrome

A

pineal gland tumors
thalamic/midbrain hemorrhage
infarction
trauma

31
Q

what is damaged in weber syndrome

A

fascicle of cn 3
corticospinal tract
corticobulbar tract

32
Q

findings in weber syndrome

A

ipsilateral oculomotor paresis
ptosis
dilated pupils
contralateral hemiplegia including lower face

33
Q

common cause of weber syndrome

A

occlusion of median and paramedian perforating arteries of midbrain

34
Q

what is damaged in claude syndrome

A

fascicle of cn 3

dentatothalamic projections

35
Q

findings in claude syndrome

A

ipsilateral oculomotor paresis
ptosis
dilated pupil
contralateral cerebellar dysfunction

36
Q

what is damaged in benedikt syndrome

A 
fascicle of cn 3
red nucleus
corticospinal tract
medial lemniscal tract
spinothalamic tract
37
Q

findings in benedikt syndrome

A

ipsilateral oculomotor paresis
ptosis
dilated pupil
contralateral involuntary movements (intention tremor, ataxia, chorea)
contralateral hemiparesis and hemianesthesia

38
Q

what is damaged in nothnagel syndrome

A

TECTUM
cn 3
rimlf
dentatothalamic projections

39
Q

findings in nothnagel syndrome

A

ipsilateral oculomotor palsy
contralateral upward gaze palsy
ipsilateral or contralateral ataxia

40
Q

what is damaged in locked in syndrome

A

cst in ventral pons
corticobulbar tracts
nuclei and fibers of cn 6

41
Q

findings in locked in syndrome

A 
quadriplegia
preserved consciousness
unable to speak
cannot move face
limited horizontal eye movement
42
Q

what is damaged in raymond cestan syndrome

A

sup and mid cerebellaar peduncles
sensory and motor cn 5
spinothalamic tract and medial lemniscus
cst

43
Q

findings in raymond cestan syndrome

A

ipsilateral ataxia and coarse intentioni termor
ipsilateral paralysis of musclesof mastication
facial sensory loss
contralateral hemianesthesia
cotnralateral hemiparesis of face and body
ipsi hori gaze palsy

44
Q

what is damaged in foville syndrome

A

nucleus and fibers of cn 7
pprf
cst

45
Q

findings in foville syndrome

A

ipsi paresis of whole face
ipsi hori gaze palsy
contra hemiplegia and hemianes

46
Q

what is damaged in millard gubler syndrome

A

cn 6 and 7

cst

47
Q

findings in millard gubler syndrome

A

ipsi paresis or LR
ipsi paresis of upper and lower face
contralateral hemiplegia

48
Q

what is damaged in wallenberg syndrome

A 
descending cn 5
cn 9 and 10
descending sympathetic fibers
inf cerebellar peduncle
spinothalamic tract
vestibbular nuclei
49
Q

findings in wallenberg syndrome

A

ipsi loss of pain and temp sensation in face
ipsi paralysis of palate, pharynx, and vocal cords
ipsi horner’s syndrome
ipsi ataxia and dysmetria
contra hemianes
vertigo, nausea, vomiting, nystagmus

50
Q

what is damages in dejerine syndrome

A

cn 12, cst, medial lemniscus

51
Q

findings in dejerine syndrome

A

ipsi paresis of tongue
contralateral hemiplegia
contra loss of position and vibratory sensation

08 Neuro (24 decks)

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