strokes - effects and locale

Question 1

MCA stroke

Answer 1

motor cortex - upper limb and face - contralateral motor loss
sensory cortex - upper limb and face - contralateral sensation loss
temporal/frontal lobe - wernickes/brocas - nondominant = hemineglect. dominant - aphasia

Question 2

ACA stroke

Answer 2

motor cortex - lower limb - contralateral paralysis

sensory cortex - lower limb - sensory loss contralateral

Question 3

lenticulostriate stroke

Answer 3

striatum and internal capsule - contralateral heimpariesis/hemiplegia

secondary to unmanaged hypertension

Question 4

ASA stroke

Answer 4

lateral corticospinal tract - contralateral hemiparesis of upper and lower limbs
medial lemniscus - decreased contralateral sensory
caudal medulla - hypoglossal nerve - ipsilateral tongue deviation

Question 5

ASA stroke are commonly unilateral or bilateral

Answer 5

bilateral. look at the supply

Question 6

what vessel for medial medullary syndrome

Answer 6

paramedian branches of ASA and vertebral arteries

Question 7

describe medial medullary syndrome using the rule of fours

Answer 7

medial: motor nuclei, motor pathway, MLF, medial lemniscus
medullay: CN IX, X, XI, XII medial = XII

Question 8

PICA stroke

Answer 8

lateral medulla: vestibular nuclei, lateral spinothalamic tract, spinal trigeminal nucleus, nucleus ambiguous, sympathetic fibres, inferior cerebellar peduncle

Question 9

describe symptoms of PICA stroke

Answer 9

vestibular nuclei - vomiting, vertigo, nystagmus
lateral spinothalamic tract - decreased pain and temperature from contralateral body
trigeminal nucleus - pain an temperature ipsilateral face
nuceus ambiguous - dysphagia, hoarseness, decreased gag reflex
sympathetic fibres - ipsilateral horner syndrome
inferior cerebellar peduncle - ataxia and dysmetria

Question 10

describe symptoms of PICA stroke with the rule of fours please

Answer 10

lateral medulla
CN: IX, X, XI
pathways: spinothalamic, sensory of V, spinocerebellar, sympathetic fibres

Question 11

what is lateral medullary syndrome aka

Answer 11

Wallenberg

PICA

Question 12

don’t pica hoarse that cant eat

Answer 12

lateral medullary syndrome/wallenberg

Question 13

AICA stroke

Answer 13

lateral pontine: cranial nerve nuclie, vestibular nuclei, facial nucleus, spinal trigeminal nucleus, cochlear nuclei, sympathetic fibres, middle and inferior cerebellar peduncles

Question 14

sxs of AICA stroke pelase

Answer 14

CN nuclei: (lateral pons = CN sensory and motor V, not six, CN VII, CN VIII) –> paralysis of facevomting, vertigo, nystagums, lacrimation, taste from anterior 2/3 tongue
spinal trigeminal nucleus : ipsilateral pain and temperature of face
sympathetic fibres: ?
middle and inferior cerebellar peduncles: ataxia and dysmetria

Question 15

rule of fours for alteral pontine syndrome please

Answer 15

AICA

lateral: spinocerebellar, spinothalamic, sympathetic, sensory of V
pontine: V, VI (medial), VII, VIII

Question 16

PCA stroke

Answer 16

occipital cortex and visual cortex - contralateral hemianopial with macular sparing

Question 17

basilar artery stroke

Answer 17

pons, medullat, lower midbrain, corticospinal and corticbulbar tracts, ocular cranial nerve nuclie, paramedian pontine reticular formation
= preserved consciousness and blinking, quadriplegia, loss of voluntary facial, mouth and tongue movements.
LOCKED IN SYNDROME

Question 18

what is locked in syndroem

Answer 18

basilar artery stroke - preserved consciousness and blinking, quadriplegia, loss of voluntary facial, mouth, tongue movements.

Question 19

most common lesion in the anterior communicating please

Answer 19

ANEURYSM - stroke - impingment of CN - II

Question 20

most common lesion in the posterior communicating

Answer 20

saccular aneurysms - CN III palsy - down and out with ptosis and mydriasis

Question 21

DO THEM ALL BACKWARDS NOW BECKY

Answer 21

hurrah :)