Stroke and vascular neurology Flashcards
Ataxic hemiparesis
Posterior limb of internal capsule - MCA penetrating arteries (lenticulostriate) or
Basis pontis - Basillar penetrating arteries
Contralateral ataxia and weakness upper and lower limb
Gerstmann’s syndrome
Dominant parietal lobe lesion
Right left confusion
Finger agnosia
Agraphia
Acalculia
Inferior branch of the middle cerebral artery
Contralateral homonymous hemianopia or Upper quadrant anopsia
Contralateral receptive aphasia
Contralateral constructive apraxia
Middle cerebral artery - superior division
Superior parietal lobe, lateral frontal lobe
Contralateral weakness face, arm >leg
Contralateral sensory loss of face, arm >leg
Contralateral lower quandrantanopia
Contralateral expressive dysphasia (Dominant)
Contralatearl hemineglect (non-dominant)
Alexia without agraphia
Pure word blindness (can write but not read)
Collosal branches of posterior cerebral artery
Alexia (splenum of corpus callosum)
Contralateral homonymous hemianopia
Balint Syndrome
Bilateral posterior cerebral artery (bilateral parietal occipital lobes)
Optic ataxia
Loss of voluntary eye movements
Asimultagnosia - inability to understand visual objects
Claude syndrome
Midbrain tegmentum lesion
Contralateral ataxia of arm and leg
Ipsilateral occulomotor palsy
+/- Contralateral hemiparesis of face and arm
no rubral tremor like benedikt syndrome
Benedikt’s syndrome (paramedian midbrain syndrome)
Ipsilateral CNIII lesion
Contralateral hemiataxia upper and lower limb
Rubral tremor
Weber syndrome
Contralateral upper and lower limb weakness
Ipsilateral CNIII
Anton Syndrome
Cortical blindness and unawareness
Bilateral PCA or top of basilar
Posterior artery- unilateral
Contralateral hemianopia only
Dejerine-Roussy syndrome
Posterior cerebral artery penetrating thalamus
Contralateral sensory loss face, arm leg
Contralateral pain face arm leg
Lateral pontine syndrome (Marie-Foix syndrome)
Anterior inferior cerebellar artery OR
Long penetrating branches of basillar
Ipsilateral ataxia
Contralateral hemiparesis
Contralateral loss of pain and temperature only
Lateral medullary syndrome (Wallenburg syndrome)
Posterior inferior cerebellar syndrome
Contralateral loss of pain and temperature -arm and leg
Ipsilateral loss of pain and temp - face (+/- pain)
Ipsilateral Horner’s syndrome
Ipsilateral ataxia
Ipsilateral nystagmus and vertigo
Nausea vomiting and severe dysphagia
Hiccups
Inferior median pontine syndrome (Foville syndrome)
Basillar artery - paramedian branches
Contralateral weakness arm and leg
Ipsilateral weakness of face
Ipsilateral gaze palsy (paramedian pontine reticular formation or CNVI nucleus)
Locked in syndrome
Bilateral ventral pontine syndrome - basilar artery
Quadriplegia
Bilateral facial weakness
Bilateral gaze weakness
Dysarthria
Patient fully awake, sensation fully spared
Medial medullary syndrome (Dejerine syndrome)
Anterior spinal artery
Ipsilateral CNXII lesion (tongue toward lesion)
Contralateral weakness arm and leg
Contralateral loss of vibration and prioception (medial lemniscus)
Raymond syndrome
Ventral median pontine syndrome - paramedian arteries of basillar
Ipsilateral CNVI lesion - lateral gaze weakess
Contralateral upper and lower limb weakness
Millard-Gubler syndrome
Basis pontis - paramedian branches of basillar
Ipsilateral CNVI lesion - lateral gaze palsy
Ipsilateral facial weakness
Contralateral arm and leg weakness
Three nuclei of CNIII
Superior rectus subnucleus - innervates the contralateral superior rectus
Levator subnucleus - bilateral levator palpebrae Ipsi>contra
Edinger-Westfall nucleus- pupillary constriction ipsilaterally
Differentials for CNIII palsies
PCOM/ICA/PCA aneurysm - dilated pupil, headache
Infiltration/thrombus in cavernous sinus - CNVI, CNIV, CNIII with smaller pupil, CNV1 numbness
Ischaemic nerve (diabetes) - ptosis, occulomotor palsy, pupillary sparing
Midbrain lesion - Weber, Claude or Benedikt syndrome
Trauma
Opthalmoplegic migraine
Myasthenia, thyroid eye disease
