Stroke anatomy

Question 1

What is meant by gyrus and sulcus?

Answer 1

Gyri are the elevated folds of the brain

Sulci are the grooves between the gyri

Question 2

Where is Broca’s area found, what is it responsible for and what would a patient present with if they had damage to this area?

Answer 2

Found on the inferior frontal lobe

Responsible for expression of speech

Damage to Broca’s area would cause expressive aphasia

Question 3

What would damage to Wernicke’s area cause?

Answer 3

Receptive aphasia (inability to understand language)

Found in temporal lobe

Question 4

What will a compromised anterior cerebral artery supply cause?

Answer 4

Damage to the frontal lobe and pre-central gyrus causing personality changes and contralateral motor paralysis of the leg

Question 5

What are the clinical effects of a compromised middle cerebral artery?

Answer 5

CHANGes
- Contralateral hemiparesis of lower part of the face and arm
- Homonymous hemianopia
- Aphasia
- Neglect
- Gaze preference to side of lesion

Question 6

What are the clinical signs of compromised blood flow from the posterior cerebral artery?

Answer 6

4 Ds
- Diplopia
- Dizziness
- Dysarthria
- Dysphagia

Question 7

What does the occlusion of the post-central gyrus result in?

Answer 7

Impaired ipsilateral sensation (mainly of the leg)

Question 8

What are the signs of 3rd nerve palsy?

Answer 8

3 Ds
- Divergent squint
- Dilated pupil
- Dropping of eyelid (ptsosis)

Muscles innervated by CN3: Superior rectus / Inferior rectus / Inferior oblique / Medial rectus / levator palpebrae superioris (raises eyelid) / Sphincter papillae (constrict pupils via parasympathetic supply)

Question 9

What would a patient be unable to do with 4th CN palsy?

Answer 9

Unable to look at the floor while abducting their eyes

Question 10

What would a patient present with if they had 6th CN palsy?

Answer 10

Inability to abduct their eyes

Question 11

What are the symptoms associated with Horner’s syndrome?

PAM is horny

Answer 11

PAM is horny (Horner’s)

• Ptosis
• Anhidrosis of affected side of face
• Miosis (pupil constriction on affected side of the face)

Question 12

What neurological syndrome can a Pancoast tumour cause and which vertebral level would this compression occur?

Answer 12

Horner’s syndrome

Compression of stellate ganglion (2nd neuron) at T1