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EANS > Symtoms correlated to brainareas > Flashcards

Symtoms correlated to brainareas Flashcards

1
Q

Schmidt syndrome

A

CN X and XI = vagospinal syndrom
- unilateral vocal cord, sternocleidomastoideal, soft palate, larynx and trapezius paralysis.

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2
Q

Jacksons syndrome

A

CN X, XI o XII palsy
- unilateral paralysis of sternocleidomastoideus, soft palate, larynx, vocal cords, trapezius and tongue.
( men obs, denne jackson är nog mer känd för Jacksonian EP.)

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3
Q

Tapia syndrome

A

= Matadors disease = CN X and XII palsy
* hoarsness of voice
* dysphagia secondary to incoordination of tongue.
* Food bolus propulsion
* unilateral arophy and paralysis of tongue
* sometimes paralysis of SCM and trapezius.
not affecting soft palate.

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4
Q

Causes of Tapia syndrome?

A
  • oral intubation
  • metastases
  • rarely associated to carotid or vertebral dissection.
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5
Q

Villarets syndrome

A

AKA posterior retropharyngeal syndrome
AKA nervous syndrome of the posterior retroparotid space.
CN IX, X, XI o XII + sympathetics
= Collet Sicard syndrome + horner syndrome.
= Collet Sicard syndrome with sympathetic involvement.

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6
Q

Etiologies of Villarets syndrome

A

parotid tumors, metastases, external carotid aneurysm and osteomyelitis of the skull base

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7
Q

Collet-Sicard syndrom

A

CN IX, X, XI and XII. No symp. involvement.
More likely w lesions outside the skull.
IF caused by IV lesion it would have to be so large that it would usually produce brainstem compression….—Long tract finding (not incl in the syndrome)
* unilateral paralysis of palate, vocal cords, SCM, trapezius, tongue.
*Loss of taste in post 1/3 of tongue,
*Anesthesia of soft palate, larynx and pharynx.

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8
Q

Etiologies to Collet-Sicard syndrome

A
  • Condylar and Jeffersons fractures
  • Internal carotid dissection
  • Primary and metastatic tumors
  • Lyme disease
  • Fibromuscular dysplasia
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9
Q

What structures pass through the Jugular foramen?

A

From medial (foramen magnum) side to lateral:
Inferior Jugular Vein, CN XI, X, IX, Inferior Petrosal Sinus.
AND! posteriolaterally there is a large compartment passing the sinus sigmoideus!

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10
Q

What structure passes through the sigmoid segment of foramen jugulare?

A

Inferior jugular vein

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11
Q

What structures passes through the interjugular segment of foramen jugularis?

A

CN XI, X and IX.

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12
Q

What structures passes through the petrosal segment of foramen jugulare?

A

Inferior petrosal sinus.

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13
Q

What structures passes through Pars vascularis of foramen jugulare?

A

Inferior jugular vein, CN XI and CN X. + branching Arnolds nerve

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14
Q

What structures passes through Pars Nervosa of foramen jugulare?

A

CN IX and Inferior petrosal sinus.

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15
Q

Through what opening in the skull base is CN XII exiting?

A

The hypoglossal canal.

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16
Q

What is the function of CN IX from jugular foramen?

A

loss of taste, and sensation of posterior third of tongou

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17
Q

What is the signs of CN X injury in the jugular foramen?

A

paralysis of vocal cords, palate, anesthesia of pharynx and larynx.

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18
Q

What is the function of CN XI -accessorius- from foramen jugulare

A

weak trapezius and SCM

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19
Q

what would a lesion of CN XII in the hypoglossal canal cause?

A

tongue paralysis and atrophy

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20
Q

What symtom in the face is seen from compression of the sympathics?

A

Horner syndrome

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21
Q

What encompasses Horners syndrome?

A

Ipsilateral ptos, miosis, anhidrosis in the face (if not only sympathetics running along ICA is involved because the hidrosis sympathics run with ECA).

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22
Q

what constitutes the foramen jugularis?

A

It is a opening inbetween the petrous part of the temporal bone, and the lateral side of the occipital bone. Usually there is a bony spine from the petrous part dividing it in two parts.

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23
Q

What separates foramen jugulare from the carotid canal?

A

Only the carotid ridge.

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24
Q

Parinauds syndrome

A

= dorsal midbrain syndrome AKA pretectal syndrome

“A supranuclear paralysis of vertical gaze resulting from damage to the mecencephalon”

  • supranuclear upward gaze palsy (sunset sign)
  • lid retraction (colliers sign)
  • convergence palsy
  • acommodation palsy
    + less common associations, see another card.
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25
Q

What does a supranuclear upward gaze palsy mean physiologically?

A

Upgaze palsy affecting both voluntary saccadic and pursuit movements, with perservation of vestibulo-ocular or oculocephalic (dolls eyes) reflexes in most cases. Horizontal eye movement spared.

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26
Q

Colliers sign

A

lid retraction -bilateral or unilateral (midbrain lesion)

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27
Q

What is Millard Gubler syndrome?

A

VII and VI palsy + contralateral hemiplegia

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28
Q

Where is the injury situated in a Millard Gubler syndrome?

A

lesion in base of pons. Affecting both nerves (VI and VII) and the corticospinal tract.

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29
Q

Where is the injury situated if the pt has ipsilateral facial palsy, ipsilateral inability to look laterally and contralateral hemiplegia?

A

base of pons. = Millard Gubler syndrome

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30
Q

What is Benedikts syndrome?

A

Webers syndrome + red nucleus lesion.
This means:
* CN III lesion w relatively pupil sparing
* contralateral hemiparesis BUT NOT the arm which has hyperkinesia, ataxia and coarse intention tremor

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31
Q

Where is a benedikts syndrome situated (what structures does it involve)?

A

Midbrain tegmentum plus red nucleus, brachium conjunctivum and fascicles of CN III.

32
Q

What is Webers syndrome?

A

CN III palsy w contralateral hemiparesis. see lacunar strokes p 1334.
third nerve palsies from parenchymal lesions may be relatively pupil sparing.

33
Q

Cerebellar mutism

A

AKA mutism w subsequent dysarthria

Speechlessness that follow various cerebellar injuries; trauma, cerebellit etc etc. Most often child after surgery. Unkown what structure causes this. ( på beito sade de vermis?)

34
Q

Prognosis after cerebellar mutism?

A

Most get better but its rare to be fully back.

35
Q

What is cerebellar mutism SYNDROME?

A

Its cerebellar mutism +
ataxia + hypotonia + irritability

36
Q

What is posterior fossa syndrome?

A

cerebellar mutism syndrome +
CN deficits + neurobehavioural changes + urinary incontinence or retention

37
Q

What is cerebellar syndrome?

A

ataxia, dysmetria and nystagmus

38
Q

What is the incidence of cerebellar mutism following surgery for cerebellar tumors?

A

11-29%

39
Q

Clinical characteristics of cerebellar mutism?
* onset time
* duration
*% w sequele

A

Onset between 1-6 days postop.
Limited duration 4d-4mo
long term linguistic sequele 98.8% of pt.

40
Q

What does the term “ cerebellar diaschisis” mean?

A

“shocked all through” - cerebellar mutism har been linked to disruption of cerebello-cerebral circuits such as the dentatethalamocortical tract.

41
Q

What is Foster Kennedy syndrome?

A

Classical triad:
* ipsilateral anosmia
* ipsilateral central scotoma
* contralateral papilledema

occasionally ipsilateral proptosis will also occur.

42
Q

Why is ipsilateral central scotoma seen in foster Kennedy syndrome?

A

Due to pressure on the optic nerve and secondary optic atrophy.

43
Q

Anton-Babinski syndrome

A

Unilateral asomatognosia.
may be obscured by aphasia if occuring on dominant side.
* anosognosia
* apathy
* allocheiria
* dressing apraxia
* extinction
* inattention to an entire visual field with deviation of head, eyes and body to unaffected side. ( w or wo hemianopsia)

44
Q

location of Anton-Babinski syndrome

A

parietal (usually detected if situated on non-dominant side)

45
Q

Frontal lobe unilateral

A

may go without detectable findings

46
Q

Frontal lobe bilateral

A

apathy and abulia

47
Q

deletion of frontal Brodman area 8

A

impaired gaze towards contralateral side - the patient look towards the lesioned side.

48
Q

irritative lesions (eg seizures) in frontal Brodman area 8

A

activation of gaze towards contralateral side.

49
Q

Where is the injury in Foster Kennedy syndrome

A

Olfactory groove lesion
eg medial third sphenoid wing tumor

50
Q

What are the signs of Foster Kennedy syndrome

A
  • Ipsilateral anosmia
    *Ipsilateral SCOTOMA
    *CONTRA lateral papilledema (due to ICP)
51
Q

What executive functions are situated in the frontal lobe?

A

Planning, prioritizing, organising, suppressing impulses, understanding consequences of decisions.

52
Q

lesions in the olfactory groove may lead to this syndrome

A

Foster Kennedy syndrome

53
Q

injuries to the prefrontal lobes may result in

A

diffficulties:
*planning
*prioritizing
*organizing thoughts
*suppressing impulses
*understanding consequenses of decisions

54
Q

Injuries to either side of the parietal lobe may lead to:

A
  • cortical sensory syndrome
  • sensory extinction
  • contralateral homonymous hemianopsia
  • contralateral neglect
55
Q

Injuries specific for the dominant parietal lobe?

A
  • Aphasias
  • Gerstmanns syndrome
  • Bilateral astereognosis
56
Q

Injuries specific to the non-dominant parietal region

A
  • topographic memory loss
  • anosognosia
  • dressing apraxia
  • integration of visual and proprioceptive sensation to allow manipulation of body and object and for certain constructional activities.
57
Q

Describe classical findings of Gerstman syndrome

A

Dominant parietal lobe injury -
*Agraphia w/o alexia
*Left-right confusion
*Digit Agnosia
*Acalculia

58
Q

Findings in Injuries to occipital lobe

A

homonymous hemianopsia

59
Q

injuries to cerebellar hemisphere

A

ataxia in ipsilateral limb

60
Q

What is pathology is seen in injuries to cerebellar vermis

A

truncal ataxia

61
Q

Syndrome where injuries to the pineal region is seen?

A

Parinaud s syndrome

62
Q

Another name of the Wallenberg syndrome?

A

The lateral medullary syndrome

63
Q

What main structure is involved in the Wallenberg syndrome?

A

According to litterature it is PICA, but in reality VA is probably causing the typical symtoms more often.

64
Q

What symtoms are seen in Wallenberg syndrome?

A
  • injury to nucleus ambiguus give ipsilateral palatal, pharyngeal and vocal cord paralysis
  • Additionally: ipsilateral FACIAL numbness, contralateral TRUNCAL numbness, ipsilateral horners syndrome, vertigo, nausea, vomiting and occasionally hick-ups.
65
Q

What is vermian split syndrome?

A
  • Nystagmus
  • Gait disturbance
  • Oscillation of head and neck
  • truncal ataxia
  • Equilibrium disturbance
    !!! Peds - CEREBELLAR MUTISM!!!
66
Q

Describe Horners syndrome

A

Minskat sympatikuspåslag
* liten pupill (mios)
* Ptos (lätt)
* Nedsatt svettning ansiktshalvan
* Rodnad och tempstegring i huden

67
Q

Signs of Foster Kennedy syndrome?

A
  • Ipsilateral optic nerve atrophy and central scotoma
  • contralateral papill edema
    sometimes ipsilateral anosmia
68
Q

What CN are affected in Vernets syndrome?

A
  • Vagus nerve
  • Accessory nerve
  • Glossopharyngeal nerve
69
Q

What is nystagmus retractorius?

A
70
Q

WHat is a cortical sensory syndrome?

A

lesion in postcentral gyrus causing
* loss of position sense
* loss of passive movement sense
* inability to localize tactile, thermal or noxious stimuli
* asterognosi
* agraphestesi
* lost 2p discrimination
* easy fatigability of sensory perceptions
* difficulty distinguishing simultaneous stimulations
* prolongation of superficial pain with hyperpathia - nociceptive stimuli evolve, exaggravated levels of pain.
* touch hallucinations

71
Q

Why are lids retracted in perinaud s syndrome?

A

The cause is thought to be due to damage to the levator inhibitory fibers at the posterior commissure.

72
Q
A
73
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74
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75
Q
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76
Q
A

EANS (31 decks)

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