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S&F: Exam 2 > Stroke Syndromes > Flashcards

Stroke Syndromes Flashcards

0
Q

Ischemic Stroke

A

Occlusion of a blood vessel; more common than hemorrhagic

*Thrombotic are most common

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1
Q

Hemorrhagic Stroke

A

Rupture of an aneurysm (Anterior communicating arteries)

  • Produces crescent shaped CT image
  • Will see severe headache, nuchal rigidity, and decreased consciousness
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2
Q

Lacunar infarct

A

Small infarcted area due to occlusion of small end artery

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3
Q

Watershed infarct

A

Occurs b/w distribution of two mjor arterie

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4
Q

TIA

A

Transient Ischemic Attack

Normal fnxn returns in 30mins-24hrs

*Assoc. w/ increased risk for stroke; possibly within hours

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5
Q

Ischemic cascade

A

Death of neuronal cells causes excess release of glutamate

=>Ca2+ into other cells causing their death as well

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6
Q

Pnumbra

A

Area surrounding center of infarction in which damage is not yet irreversible

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7
Q

Lesion of optic chiasm

A

Produces a bitemporal hemianopsia

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8
Q

Lesion central to optic chiasm

A

Produces homonymous hemianopsia

-(Optic tracct, lateral geniculate nucleus of thalamus, Area 17)

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9
Q

ICA Stroke

A
  • May have amaurosis fugax due to occlusion of CRA
  • Global aphasia
  • Eye deviation to side of lesion
  • Tongue deviation away from lesion

Contralateral:
Spastic paralysis w/ Babinski (Primary Motor Cortex)
Paralysis of lower face (UMNs of VII)
Loss of fine touch, vibration, conscious proprioception (SI)
-Pt. cannot localize pain either

Ipsilateral:
Vision loss

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10
Q

MCA stroke

A

-Global aphasia if on left

Contralateral:
Spastic paralysis (Lateral part of Area 4)
Loss of fine touch, vibration, conscious proprioception (Lateral part of Areas, 3,1,2)
No pain localization (Lateral part of Areas 3,1,2)
*All upper body > lower body

Ipsilateral: 
Eye deviation towards lesion
Tongue deviation away from lesion
Neglect
`
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11
Q

ACA stroke

A

-Abulia, akinetic mutism, urinary incontinence

Contralateral:
Spastic paralysis w/ Babinski (Medial part of Area 4)
Loss of fine touch, vibration, conscious proprioception (Medial Areas 3,1,2)
No localization of pain (Medial Areas 3,1,2)

*Upper body > Lower body

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12
Q

PCA stroke

A

-Contralateral homonymous hemianopsia w/ macular sparing

  • Memory deficits
    • Due to damaged hippocampus
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13
Q

Abulia

A

Loss of ability to act voluntarily

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14
Q

Akinetic mutism

A

Decreased thought, movement, speech, emotion

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15
Q

Amaurosis fugax

A

Sudden transient loss of vision on one side due to occlusion of CRA

-TIA symptom

16
Q

Stroke of lenticulo-striate branches

A

Supply genu and posterior limb of internal capsule (subcortical area)

Contralateral:
Spastic paralysis w/ Babinski 
Loss of fine touch, vibration, conscious proprioception
No ability to localize pain
Lower facial paralysis
  • damaged corticobulbar and corticospinal axons
  • will not see any cortical signs
17
Q

Thalamic strokes

A
  • Involve penetrating branches of PCA
  • Symptoms assoc. w/ branches involved
  • Produces thalamic syndrome if VPL is involved
18
Q

Weber’s Syndrome

A

Stroke of penetrating branches of PCA

-Affects basal area

Contralateral:
Spastic paralysis w/ Babinski (PLIC)
Lower facial paralysis

Ipsilateral:
Oculomotor opthalmoplegia

19
Q

Oculomotor opthalmoplegia

A

Damage to CN III

  1. Lateral strabismus
  2. Ptosis
  3. Pupil dilation
20
Q

Claude’s Syndrome

A

Stroke of PCA or basilar artery

-Affect tegmentum of midbrain

Contralateral:
Tremor (Red nucleus)

Ipsilateral:
(Oculomotor opthalmoplegia

21
Q

Benedikt’s Syndrome

A
  • Stroke of penetrating branches of basilar artery

- Involves basal and tegmental areas => combination of Weber’s and Claude’s syndromes

22
Q

Rostral pons strokes (Basal)

A

-Pontine arteries

Contralateral:
Spastic paralyis w/ Babinski (corticospinal axons)
Lower face paralysis (corticobulbar axons)

23
Q

Rostral pons stroke (Tegmentum)

A

-Pontine arteries

Contralateral:
Loss of fine touch, vibration, conscious proprioception (Medial lemniscus)

Ipsilateral:
Facial sensory loss (V axons)

*Corneal reflex in ipsilateral side would be lost

24
Q

Caudal pons stroke (Basal)

A

-Pontine arteries

Contralateral:
Spastic paralysis w/ Babinski (corticospinal axons)
Lower face paralysis (possible; could also be total ipsilateral)

25
Q

Caudal Pons Stroke (Tegmentum)

A

-Pontine arteries

Ipsilateral: 
Facial paralysis (VII nucleus/axons)
Medial strabismus (VI nucleus/axons)

*Could be many other symptoms (medial lemniscus) but these 2 are DIAGNOSTIC

26
Q

Locked-in syndrome

A

Bilateral syndrome of basal pons occurring after basilar artery stroke

-Entirely paralyzed except for vertical eye movement
(Vertical gaze center found in PAG)

*Pt not in full coma because RAS is intact

27
Q

Wallenburg’s Syndrome

(Lateral medullary syndrome)

(PICA syndrome)

A

-Stroke involving branches of PICA

Contralateral:
Loss of pain and temp. sensation (Lateral spinothalamics)

Ipsilateral:
Loss of pain and temp. in face (Spinal tract/nucleus of V)
Vertigo, nystagmus, nausea, vomiting (Vestibular nuclei)
Ataxia (Inferior cerebellar peduncle)
Horner’s Syndrome (Sympathetic projections in lateral spinothalmic area)
Absent gag reflex, dysponia, dsypnea, dysphagia (Nucleus ambiguus)

28
Q

Horner’s Syndrome

A

Damage to sympathetic axon on their way to the intermediolateral cell column @ T1-L2

1 Miosis

  1. Ptosis
  2. Anhydrosis
29
Q

Medial medullary syndrome

A

-Stroke of medial medullary branches of vertebral artery

-Contralateral:
Loss of fine touch, vibration, conscious proprioception (medial lemniscus)
Spastic paralysis w/ babinski (pyramids)
Deviation of tongue to side of lesion (axon of CN XII)

Ipsilateral:
Possible atrophy and fasciculations (inferior cerebellar peduncle possible)

30
Q

Spinal cord stroke

A
  • Anterior/vertebral arteries
  • Symptoms will be assoc. w/ pathways affected
  • Presents w/ NO CORTICAL OR CN SIGNS
31
Q

Corticobulbar tract

A

UMN innervation for cranial nerves

-Axons originate in cortex and terminate in motor nuclei of CNs

32
Q

Dead Reds

A

Red stained neurons that are pathognomonic for ischemic stroke

S&F: Exam 2 (17 decks)

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