Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

neurology FA + STEP 2 > strokes > Flashcards

strokes Flashcards

1
Q

strokes - anterior circulation - arteries

A
  1. middle cerebral artery
  2. anterior cerebral artery
  3. lenticulo-striate artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

stroke on middle cerebral artery - area of lesion

A 
motor cortex - upper limb and face 
sensory cortex - upper limb and face 
termpal lobe - wernicke area 
frontal lobe - broca area 
if in dominant --> aphasia 
if non dominant --> hemineglect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

stroke on anterior cerebral artery - area of lesion

A

motor cortex - lower limb

sensory cortex - lower limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

stroke on lenticulo-striate artery - area of lesion

A
  1. striatum

2. internal capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

stroke on lenticulo-striate artery - symptoms

A

Contralateral hemiparesis/hemiplegia (face + body)

absence of cortical signs. eg. neglect, aphasia, visual field loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

a common cause of stroke on lenticulo-striate artery - and why

A

2ry to unmanaged hypertension because is a common location of lacunar infarcts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

strokes - posterior circulation - arteries

A
  1. anterior spinal artery
  2. posterior inferior cerebellar artery
  3. anterior inferior cerebellar artery
  4. posterior cerebral artery
  5. basilar artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

stroke of basilar artery - area of lesion (areas and structures)

A
  1. pons, medulla, lower midbrain,
  2. corticospinal and corticobulbar (UMN)
  3. ocular cranial nerve nuclei
  4. paramedian pontine reticular formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

stroke of basilar artery - symptoms

A

locked-in syndrome :

  1. preserved consciousness, blinking + vertical eye movement
  2. quadriplegia
  3. loss of voluntary facial, mounth and tongue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

stroke of anterior spinal artery - area of lesion and symptoms

A
  1. lateral corticospinal tract - contralateral hemiparesis (upper and lower limbs)
  2. medial lemniscus - decreased contralateral proprioception
  3. Caudal medulla/hypoglossal nerve - ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

medial medullary syndrome is caused by

A

infarct of paramedian branches of anterior spinal artery and vertebral arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

stroke of posterior inferior cerebellar artery - area of lesion

A 
lateral medulla (Lateral medullary (wallenberg) syndrome): 1. vestibular nuclei 2. lateral spinothalamic tract  3. spinal trigeminal nucleus  4.  nucleus ambiguus (vagus) (μεικτός), 5. sympathetic fibers 
 6. inferior cerebellar peduncle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

stroke of posterior inferior cerebellar artery - symptoms

A

vomiting, vertigo, nystagmus, decreased pain and Q sensation from ipsilateral face and contralateral body, dysphagia, hoarness, decreased gag reflex, ipsilateral Horner, ataxia, dysmetria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lateral medullary (wallenberg) syndrome (specific involvement)

A

POSTERIOR INFERIOR CEREBELLAR ARTERY SYNDROME (STROKE)

nucleus ambiguus effects are specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

stroke of posterior cerebral artery - area of lesion / symptoms

A

occipital cortex
visual cortex
- contralateral hemianopia with macular sparing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

stroke of anterior inferior cerebellar artery - area of lesion

A

lateral pons: (LATERAL PONTINE SYNDROME)

  • cranial nerve nuclei (vestibular, facal, spinal trigeminal, cochlear,)
  • sympthathetic fibers
  • middle and inferior cerebellar peduncles
  • lateral spinothalamic tract
  • corticospinal tract
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

stroke of anterior inferior cerebellar artery - symptoms

A

LATERAL PONTINE SYNDROME

  • vomiting, vertigo, nystagmus
  • face paralysis, decreased lacrimation and salivation, decreased taste of the anterior 2/3 of the tongue
  • ipsilateral decreased pain and Q of the face and contralateral of the body
  • ataxia dysmetria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

lateral pontine syndrome - specific lesion

A

facial nucleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

anterior communicating arteries - lesion

A

most commonly saccular aneurysm (berry) that can impinge cranial nerves. It can lead to stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

anterior communicating arteries - symptoms

A
  • visual field defects (bitemporal hemianopia)
  • visual acuity defecits
  • Rupture –> ischemia in ACA distribution –> contralateral lower extremity hemiparesis, sensory deficits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

central post-stroke pain syndrome - definition / course / occurs in

A
  • Neuropathic pain due to thalamic lesions
  • initial paresthesias followed in weeks to months by allodynia and dysesthesia
  • 10% of stroke patient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

common locations of lacunar infarcts

A
  1. basal ganglia
  2. internal capsule
  3. thalamus
  4. pons
    (Oxford handbook)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

stoke - dysphagia and hoarseness - artery?

A

posterior inferior cerebellar artery

24
Q

stroke - paralysis of face and loss of lacrimation - artery

A

Anterior inferior cerebellar artery

25
Q

intracranial hemorrhage - types

A
  1. epidural hematoma
  2. subdural hematoma
  3. subarachnoid hemorrhage
  4. intraparenchymal (hypertensive) hemorrhage
26
Q

epidural hemorrhage - mechanism

A

rupture of middle meningeal artery (branch of maxillary) often often 2ry to fracture of temporal bone –> rapid expansion (artery)

27
Q

epidural hemorrhage - course

A
  • Lucid interval (a temporary improvement in a patient’s condition after a traumatic brain injury)
  • rapid expansion under systemic arterial pressure
28
Q

epidural hemorrhage - complications

A
  1. transtentorial herniation

2. CN III

29
Q

epidural hematoma - CT

A
  • biconvex (lentiform), hyperdense blood collection
  • not crossing suture lines
  • can cross falx, tentorium
30
Q

subdural hematoma - mechanism

A

rupture of bridging veins –> slow venous bleeding

(less pressure because of veins= hematoma develops over time). Can be acute or chronic

31
Q

subdural hematoma - CT

A
  • Crescent-shaped hemorrhage
  • crosses sature lines
  • Midline shift
  • Cannot cross falx, tentorium
  • findings of “acute on chronic” haemorrhage
  • if acute –> hyperdense, if chronic –> hypodense
32
Q

causes of subarachnoid hemorrhage

A
  1. rupture of an aneurysm (such as berry)

2. arteriovenous malformations

33
Q

Saccular (berry) aneurysm - associations and risk factors

A
  1. ADPKD
  2. Ehlers-Danlos syndrome
  3. advanced age
  4. hypertension
  5. smoking
  6. race (increased risk with black)
34
Q

subarachnoid hemorrhage - complications after 4-10 days

visible on CT

A
  1. vasospasm due to blood breakdown –> ischemic infract (not visible in CT)
  2. rebleed (visible in CT)
  3. high risk of developing communicating and/or obstructive hydrocephalus
35
Q

intraparenchymal (hypertensive) hemorrhage - is caused by

A
  1. hypertension (MCC)
  2. amyloid angiopathy
  3. vasculitis
  4. neoplasm
    (can cause Charcot-Bouchard)
36
Q

intraparenchymal (hypertensive) hemorrhage - area

A

typically occurs in basal ganglia and internal capsule (Charcot-Bouchard aneurysm of leniculostriate vessels)
can be lobar

37
Q

cns aneurysms - types

A
  1. Saccular (berry) aneurysm

2. Charcot-Bouchard microaneurysm

38
Q

Charcot-Bouchard microaneurysm is associated with … / area / important

A

chronic hypertension

  • it affects small vessels (eg. in basal ganglia, thalamus)
  • not seen in angiogram
39
Q

Saccular (berry) aneurysm - area

A

bifurcations in the circle of Willis

MC site is junction of anterior communicating artery and anterior cerebral artery

40
Q

Saccular (berry) aneurysm - complications

A
  1. rupture (–> subarachnoid hemorrhage or hemorrhagic stroke)
  2. bitetemporal hemianopia (via compression of optic chiasm) (anterior comm)
  3. visual acuity deficits (anterior comm)
  4. CN III palsy (posterior comm)
41
Q

aneurysm associated with hypertension - saccular or Charcot Bouchard?

A

both

42
Q

MCC and 2nd MCC of subarachnoid hemorrhage (and proportion)

A
  1. rupture of an aneurysm (such as berry) (80%)

2. arteriovenous malformations (15%)

43
Q

most vulnerable areas of ischemic brain disease (which is the most)

A
  1. hipocampus (MOST) 2. neocortex 3. cerebellum

4. watershed areas

44
Q

images can detect ischemic changes in (time)

A
  1. CT–> 6-24h (but can show almost imminently hemorrhage)
  2. diffusion-weighted MRI –> 3-30 min
45
Q

Hemorrhagic stroke is often due to

A
  1. hypertension
  2. anticoagulation
  3. cancer
  4. 2ry to ischemic stroke
46
Q

MC side of Hemorrhagic stroke

A

basal ganglia

47
Q

transient ischemic attack - definition

A

Brief, reversible episode of focal neurologic dysfunction without acute infraction (-MRI), with the majority resolving in less than 15 mins

48
Q

hypoxic ischemic stroke is due to / area / common during

A

hypoperfusion or hypoxemia / warershed areas

common during cardiovascular surgeries

49
Q

thrombotic ischemic stroke is due to / MC area

A

a clot forming directly at site of infarction usually over an atherosclerotic plague. commonly the MCA

50
Q

ischemic stroke - treatment

A
  1. tPA (if within if 3-4,5 h of onset
    no hemmorrhage/risk of hemorrhage) 2. Reduce risk with medical therapy
  2. optimum control of BP, blood sugar, lipids
  3. treat conditions that increase risk (eg. aspirin, clopidogrel)
51
Q

blood - cortical distribution - arteries and what the supply

A
  1. anterior cerebral artery –> anteriomedial surface of the cortex
  2. middle cerebral artery –> lateral surface of the cortex
  3. posterior cerebral artery –> posterior and inferior surface
52
Q

watershed zone are in danger to be damaged under / lesions

A

severe hypotension –> 1. upper leg/upper arm weakness 2. defects kn higher order visual processes

53
Q

auto-regulation - Cerebral perfusion is primarily driven by

A
  1. PCO2 (primarily)

2. PO2 (in severe hypoxia)

54
Q

autoregulation - relationship between PO2 and cerebral blood flow

A

P02 increases cerebral blood flow (until P02=50 mmHg)

PO2>50 –> plateau of cerebral blood flow

55
Q

autoregulation - relationship between PCO2 and cerebral blood flow

A

cerebral perfusion pressure increases with PCO2 until PCO2=90 mmHg
at PCO2>90 –> plateau of cerebral blood flow

neurology FA + STEP 2 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions