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Emma H&N II > Stroke Pathology > Flashcards

Stroke Pathology Flashcards

1
Q

clinical syndromic definition of a stroke

A
  • ACUTE onset
  • FOCAL neurologic deficits
  • referable to a VASCULAR TERRITORY
  • with VASCULAR RISK FACTORS
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2
Q

5 components to localization

A

1) where in the body?
2) where in the CNS
3) where is the occlusion/rupture in the vascular tree?
4) what is the source of the vascular pathology?
5) what pathology usually affects this area?

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3
Q

most common type of stroke

A
  • ischemic stroke/transient ischemic stroke
  • –arterial

85%

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4
Q

types of stroke

A
  • ischemic/TIA (arterial or venous)
  • intercerebral hemorrhage
  • subarachnoid hemorrhage
  • intraventricular hemorrhage
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5
Q

amaurosis fugax

A

transient monocular vision loss

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6
Q

transient monocular vision loss is a sign of ________, especially due to _______ disease

A

transient monocular vision loss is a sign of ISCHEMIC STROKE, especially due to CAROTID disease

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7
Q

neurologic signs from internal carotid artery occlusion

A

Retina, frontal/temporal/parietal lobes

  • amaurosis fugax (monocular vision loss)
  • Horner’s syndrome
  • aphasia
  • weakness (2): face, arm, leg
  • visual field loss
  • sensory (2): face, arm, leg
  • gaze paresis
  • inattention
  • neglect
  • apraxia

headache/neck pain

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8
Q

neurologic signs from MCA occlusion

A

Frontal, temporal, parietal lobes

  • aphasia
  • weakness: face, arm
  • visual field loss
  • sensory: face, arm
  • neglect
  • apraxia

headache/neck pain

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9
Q

neurologic signs from superior division of MCA

A

frontal lobe (lateral)

  • aphasia (nonfluent/motor)
  • weakness: face, arm
  • neglect
  • apraxia
  • gaze paresis

headache/neck pain

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10
Q

neurologic signs from inferior division of MCA

A

temporal lobe (superior, lateral), parietal lobe (anterolateral)

  • aphasia (fluent/sensory)
  • visual field loss
  • sensory: face, arm
  • neglect
  • apraxia
  • agitated delirium

headache/neck pain

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11
Q

neurologic signs from lenticulostriates occlusion

A

internal capsule, caudate, putamen, globus pallidus

  • weakness: face, arm, leg
  • sensory: face, arm, leg
  • aphasia: conduction, transcortical

NO headache/neck pain

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12
Q

abrupt, painless paralysis of a single limb –> think ____________

A

abrupt, painless paralysis of a single limb –> think ACA ISCHEMIC STROKE

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13
Q

signs/symptoms of ACA occlusion

A

frontal lobe (medial, dorsal), parietal lobe (medial, dorsal)

  • weakness: leg, +/- proximal arm
  • inattention, lethargy, abulia
  • sensory: leg +/- arm

headache/neck pain

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14
Q

signs of occlusion of recurrent arteries of Heubner

A

Caudate, internal capsule

  • abulia, akinesia
  • executive dysfunction
  • aphasia (L)
  • hemineglect (R)

NO headache/neck pain

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15
Q

posterior circulation stroke

A
  • unilateral or bilateral
  • multiple lesions
  • incomplete or partial syndrome
  • less of a vascular territory, more of a region
  • clumsiness
  • aphasia
  • anisocoria
  • loss of consciousness
  • vertigo
  • slurred speech
  • confusion
  • headache
  • weakness
  • anarthria
  • numbness
  • nausea
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16
Q

why are posterior circulation strokes more difficult?

A
  • frequently misdiagnosed
  • accompanied by non specific symptoms
  • more lethal/disabling
  • dense neuroanatomy (more numerous nuclei and tracts)
17
Q

signs of vertebral artery occlusion

A
  • occipital: visual field loss
  • thalamus
  • midbrain: medial, base, lateral
  • medulla: medial, lateral
  • cerebellum: ataxia (limb, truncal)
  • spinal cord

headache, neck pain, nausea

18
Q

signs of anterior spinal artery occlusion

A

cervical spinal cord, thoracic spinal cord

  • weakness: bilateral legs +/- arms
  • sensory: pain/temp loss

back pain, neck pain

19
Q

signs of basilar artery occlusion

A
  • occipital: visual field loss
  • thalamus
  • midbrain: medial, base, lateral
  • pons: medial, base, lateral
  • cerebellum: ataxia (limb, truncal)

headache, neck pain, nausea, depressed consciousness, convulsions

20
Q

signs of brainstem perforator occlusion

A 
-Midbrain: medial, base, lateral
OR
-Pons: medial, base, lateral
OR
-Medulla: medial lateral

NO headache or neck pain

21
Q

signs of posterior cerebral artery occlusion

A
  • occipital: visual field loss
  • thalamus
  • midbrain: medial, base, lateral
  • balint syndrome
  • gerstmann syndrome
  • anton syndrome
22
Q

Balint syndrome

A
  • simultanagnosia
  • oculomotor apraxia
  • optic ataxia
23
Q

Gerstmann syndrome

A
  • agraphia
  • acalculia
  • finger agnosia
  • left right agnosia
24
Q

Anton syndrome

A
  • cortical blindness

- confabulation

Emma H&N II (49 decks)

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