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NEUROLOGY > Stroke Syndromes > Flashcards

Stroke Syndromes Flashcards

1
Q

What occurs with lesion to the red nucleus?

A
  • loss of fine tuning of the movements

- > TREMOR AND ATAXIA

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2
Q

What occurs with lesion to the Medial Longitudinal Fasciculus?

A
  • Internuclear Ophthalmoplegia

problems with lateral gaze

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3
Q

What occurs in Benedikt Syndrome?

A
  • STROKE in the central midbrain

- —red nucleus/ CN3 and Medial leminiscus is affected#

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4
Q

What does the medial leminiscus do?

A
  • continuation of the Posterior column (relays info. on proprioception and vibration)
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5
Q

What are the symptoms of Bendikt syndrome?

A
  1. Down and Out eye+ Pupil dilation
  2. C/L Loss of proprioception and vibration
  3. Involuntary movements (TREMOR AND ATAXIA)
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6
Q

What occurs in Weber’s Syndrome? What is affected?

A
  • antero-lateral, Midbrain stroke

- —CN3/ corticobulbar/ corticospinal tracts are affected

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7
Q

How does Weber’s syndrome present as?

A
  • CN3 Palsy
  • C/L hemiparesis
  • pseudobulbar palsy
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8
Q

How to confirm dx of pseudobulbar palsy?

A
  1. Exaggerated GAG reflex and JAW reflex
  2. Spastic tongue
  3. Spastic dysarthria
    - —-UMN lesion signs
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9
Q

What is affected in Perinaud’s Syndrome?

A
  • posterior aspect of the Midbrain

- SUPERIOR COLLICULUS and the PRETECTAL area

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10
Q

What are signs of Perinaud’s Syndrome?

A
  1. Vertical Gaze Palsy

2. Pseudo Argyll Robertson Pupil

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11
Q

What is Pseudo Argyll Robertson Pupil ?

A
  • when the pupil does NOT constrict with LIGHT but it constricts with ACCOMMODATION
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12
Q

What is said to cause Perinaud’s Syndrome?

A
  • pineal tumor (Pinealoma/ Germinoma)
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13
Q

What may occur with progressive pineal tumor growth?

A
  • obstruction of the Cerebral Aqueduct
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14
Q

Describe the course of CN7 leaving pons.

A
  • does a “round-about” around CN6 and then leaves
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15
Q

What is responsible for PAIN and T* sensation on the face? Where in the brain stem is it located?

A
  • Spinal tract and the Nucleus Trigeminal

- — found in PONS

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16
Q

What is PPRF responsible for?

A
  • LATERAL gaze

paramedian pontine reticular formation

17
Q

Name 3 key fts in the PONS, repsonsible to look left or right. Where are they found?

A
  • Abducens N.
  • PPRF
  • MLF
  • —-close to each other in the midline of PONS
18
Q

What is affected in MEDIAL PONTINE $?

A
  • CN 6
  • CN 7
  • Corticospinal tract
  • —-and the lateral gaze structures
19
Q

What is seen with sx in medial pontine $?

A
  • ipsilateral CN 6 PALSY: diplopia and lateral gaze palsy
  • ipsilateral facial droop
  • c/l hemiparesis
  • -ipsilateral? gaze palsy
20
Q

What is affected in the LATERAL pontine syndrome?

A
  • Vestibular Nucleus
  • Spinothalamic tract
  • Sympathetic tract
  • Spinal V nucleus
  • CN 7 palsy
21
Q

What signs seen in the Lateral Pontine syndrome?

A
  1. nystagmus, N.V, vertigo
  2. c/l pain and T* loss on limbs
  3. HORNER’S syndrome (ipsilateral)
  4. ipsilateral loss of facial pain/T*
  5. ipsilateral FACIAL droop and LOSS of corneal reflex
  6. ….deafness (if cochlea nucleus is damaged)
22
Q

Stroke involving which artery is resp. for LATERAL pontine syndrome?

A
  • AICA

Anterior inferior Cerebellar artery

23
Q

What artery supplies the midbrain?

A

Posterior Cerebral Artery

24
Q

What does the dorsal MOTOR nucleus X and the Nucleus solitarius recieve?

A

Autonomic sensory info.

25
Q

What CNs are a.w Nucleus ambiguss?

A

CN 9, 10, 11

26
Q

What dick like structure runs in the centre of the medulla

A
  • Medial Leminiscus
27
Q

Damage to what structure in the medulla results in the Horner’s Syndrome?

A

Hypothalamospinal tract

28
Q

Which nucleus, that was seen in the pons, continues in the medulla?

A

-vestibular Nucleus

29
Q

What runs in the antero-medial aspect of the medulla? -

A

Corticospinal tract

30
Q

What occurs with Medial Medullary syndrome? Stroke in what artery results in this?

A
  • stroke of the ANTERIOR SPINAL ARTERY

- —affects the integrity of the Medial Leminiscus, corticospinal tract and CN 12

31
Q

HOw does the medial medullary syndrome present as?

A
  • c/l hemiparesis
  • c/l loss of VIBRATION and Proprioception
  • flaccid paralysis of the TONGUE (deviates to one side)
32
Q

What is affected in the Lateral Medually syndrome?

A 
Vestibular nucleus
Spinothalamic Tract
Sympathetic Tract
Spinal V fibres 
Nucleus Ambiguss
33
Q

How would Lateral Medullary syndrome present as?

A

SAME as Lateral Pontine syndrome!!

  1. Nystagmus, N.V, vertigo
  2. C.L loss of PAIN and T* on the limbs
  3. Ipsilateral loss of PAIN and T* on the FACE
  4. Horner’s Syndrome
  5. d.t involvment of Nucleus Ambiguss, additional sx of HOARSENESS and DYSPHAGIA is seen.
34
Q

What causes the Lateral Medullary syndrome?

A
  • stroke of the Posterior inferior Cerebellar artery
35
Q

What artery is involved in the Medial Pontine syndrome?

A
  • Basilar Artery
36
Q

Name the 4 Midline columns running through the Brainstem.

A
  • Motor nucleus
  • MLF
  • Medial leminiscus
  • Motor pathway
37
Q

Damage to the motor nucleus, results in what?

A

-ipsilateral MOTOR loss of CNs divisible by 12

(3,4, 6,12) —-same CNs to run MEDIALLy through out the brainstem

38
Q

What are the side columns that run throughout the brainstem?

A
  • spinothalamic tract
  • spinocerebellar tract
  • sensory nucleus (CN5)
  • Sympathetic tract
39
Q

What occurs with lesion to the Nucleus solitarius?

A
  • Rostral portion of N.Solitarius= LOSS of TASTE in Ipsilateral tongue
  • Caudal portion of N.Solitarius-increase in HR

NEUROLOGY (36 decks)

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