Stroke - anatomy

Question 1

3 things in classifying a stroke

Answer 1

higher function (speech/apraxia/neglect)
hemianopia
hemi-loss (sensory/plegia)

Question 2

total anterior circulation stroke (TACS) criteria

Answer 2

all 3 criteria

higher function, hemianopia, hemi-loss

Question 3

partial anterior circulation stroke (PACS) criteria

Answer 3

2/3 criteria

higher function, hemianopia, hemi-loss

Question 4

lacunar stroke (LACS) criteria

Answer 4

1 of:
hemiloss
pure sensory stroke
ataxic hemiparesis

Question 5

posterior circulation stroke (POCS) of occipital lobe

Answer 5

isolated homonymous hemianopia
LOC
cerebellar/brainstem syndromes

Question 6

signs of posterior circulation stroke (POCS) of cerebellum

Answer 6

ipsilateral cerebellar signs

Question 7

signs of posterior circulation stroke (POCS) of brainstem

Answer 7

ipsilateral cranial nerve palsies

bilateral sensory/motor deficit

Question 8

what areas can a POCS (posterior circulation stroke) affect?

Answer 8

brainstem
cerebellum
occipital lobe (PCA)
inferior temporal (PCA)
thalamus (PCA)

Question 9

what does MCA (middle cerebral artery) supply?

Answer 9

lateral cerebral cortex:
lateral frontal lobe
lateral parietal lobe
superior temporal lobe

Question 10

signs of middle cerebral artery (MCA) occlusion

Answer 10

contralateral:
hemiplegia (lower face, arm + leg)
sensory loss (face, arm, leg)
homonymous hemianopia
neglect
dysphasia

arm > leg

Question 11

signs of anterior cerebral artery (ACA) occlusion

Answer 11

apraxia
contralateral hemiloss (leg > arm)

(a for apraxia)
(hemiloss + planning at the side)

Question 12

what does ACA (anterior cerebral artery) supply?

Answer 12

medial cerebral cortex:
medial frontal lobe (leg)
superior-medial parietal lobe

Question 13

what does the vertebrobasilar system (vertebral + basilar arteries) supply?

Answer 13

brainstem
cerebellum
posterior cerebral artery

(think - what’s posterior?)

Question 14

what arteries does POCS (posterior circulation stroke) involve?

Answer 14

vertebrobasilar arteries - vertebral, basilar or posterior cerebral arteries (PCA)

Question 15

what arteries does TACS (total anterior circulation stroke) involve?

Answer 15

middle + anterior cerebral arteries

Question 16

what arteries does PACS (partial anterior circulation stroke) involve?

Answer 16

smaller arteries of anterior circulation eg upper/lower division of MCA

Question 17

DANISH

Answer 17

Dysdidadokinesia/dysmetria - can't flip hand; past pointing
Ataxia - unsteady; rebounding
Nystagmus + blurred vision
Intention tremor
Slurred speech
Hypotonia - weakness

Question 18

signs of posterior cerebral artery (PCA) occlusion

Answer 18

homonymous hemianopia (contralateral)
involuntary movements
sensory impairment (eg visual agnosia)

HIS - vision, senses + movement at the back

Question 19

what does the PCA (posterior cerebral artery) supply?

Answer 19

posterior cerebral cortex:
occipital lobe
thalamus
inferior temporal lobe

Question 20

how does a basilar artery stroke present?

Answer 20

locked-in syndrome

Question 21

POCS signs

Answer 21

cranial nerve palsies
bilateral sensory/motor impairment
cerebellar/brainstem signs
isolated homonymous hemianopia
LOC

POC rhymes with LOC
vision at the back