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Stroke > Types Of Stroke > Flashcards

Types Of Stroke Flashcards

1
Q 
Presentation of inferior division mca stroke
Motor loss?
Aphasia?
Eye deviation?
Other?
A

Superior quadrantanopia or homonymous hemianopsia.
Dominant hemisphere/left side - wernicke’s aphasia
Nondominant hemisphere/right side - left visual hemineglect

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2
Q

What part of the brain when affected causes conduction aphasia

A

Parietal operculum supplied by inferior division of MCA

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3
Q

What separates superior from inferior division of mca

A

Sylvian sulcus

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4
Q

%age of cardiac emboli that go to brain

A

75%

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5
Q

Which arteries supply the medulla?

A

Vertebral arteries

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6
Q

Which stroke is most commonly associated with preceding TIA

A

Thrombotic

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7
Q

What arteries are occluded in lacunar strokes

A

Deep penetrating branches of large vessels

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8
Q

Weber Syndrome
What part of brain affected?
Motor loss?
CN involved?

A

Base of Midbrain stroke - Oculomotor nerve (CN3) palsy and contralateral hemiplegia, contralateral dystaxia, caused by interpeduncular branches of PCA.

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9
Q

Which arteries supply the pons and midbrain

A

Basilar artery

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10
Q 
Presentation of one ACA
Motor loss?
Eye deviation?
Aphasia?
Other?
A

Contralateral muscle and sensory loss of lower extremity dismally.
Head and eye deviation toward lesion.
Urinary incontinence with contralateral grasp reflex and paratonic rigidity (gegenhalten).
Transcortical motor aphasia.
Gait apraxia

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11
Q

Gegenhalten

A

Paratonic rigidity - form of hypertonic with involuntary variable resistance with passive movement. Different from spasticity because there is no exaggerated DTR. Seen in ACA stroke

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12
Q

Branches of aortic arch

A

Brachiocephalic artery (which branches into R subclavian and R common carotid)
L common carotid artery
L subclavian artery

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13
Q

Which part of brain causes alexia with agraphia

A

Posterior parietal region, supplied by inferior division of MCA

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14
Q

Which strokes occur suddenly vs gradually?

A

Sudden = embolic and subarachnoid
Gradual = thrombotic and intracerebral
Sudden or gradual = lacunar

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15
Q

What does inferior division of mca supply?

A

Lateral temporal and inferior parietal lobes

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16
Q

Where is primary somatosensory cortex located

A

Prostcentral gyrus (behind central sulcus)

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17
Q

How do lacunar strokes present?

A

Pure motor or pure sensory

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18
Q

What does superior division of MCA supply?

A

Rolandic and pre-rolandic area

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19
Q

Which ischemic stroke occurs during sleep vs awake

A 
Sleep = thrombotic
Awake = embolic
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20
Q

What major vessels supply anterior circulation of brain

A

ICA, MCA, ACA

21
Q

%age of ischemic vs hemorrhagic stroke

A 
Ischemic = 85%
hemorrhagic = 15%
22
Q

Transcortical sensory aphasia

A

+fluency
-Comprehension
+Repetition
Caused by PCA stroke

23
Q

Which stroke is due to a mural thrombus

A

Embolic

24
Q

What cranial nerves are affected with PCA stroke

A

CN3 (oculumotor) and 4 (Trochlear)

25
Q

%age of thrombotic vs embolic vs lacunar vs intracerebral vs subarachnoid

A 
Thrombotic = 50%
Embolic = 20%
Lacunar = 15%
Intracerebral = 10%
Subarachnoid = 5%
26
Q

Cardiac causes of embolic stroke

A

A fib, rhd, post-mi, vegetations on heart valves, endocarditis, prosthetic heart valves

27
Q

Where does the PCA stem from?

A

Vertebral artery –> Basilar artery –> PCA

28
Q

Anton Syndrome

A

Denial of cortical blindness, caused by PCA stroke

29
Q

Prosopagnosia

A

Can’t read faces, caused by PCA stroke

30
Q

What is the cause of amaurosis fugax

A

Transient monocular blindness results from ica occlusion as it nourishes the optic nerve and retina

31
Q

What happens if both ACA is occluded?

A

Aphasia, paraplegia, incontinence, frontal lobe/personality dysfunction

32
Q

Other causes of embolus other than cardiogenic

A

Fat embolus from fracture bones, air embolus from decompression sickness, venous clot from PFO, subclavian artery thrombosis to vertebral artery

33
Q

Which stroke is associated with seizures

A

Embolic

34
Q

Which artery supplies cerebellum

A

PICA from vertebral arteries

AICA and superior cerebellar arteries from basilar artery

35
Q

Types of hemorrhagic strokes

A

Intracerebral and subarachnoid

36
Q

Where is most common location for ICA to be occluded

A

First part of ICA immediately beyond carotid bifurcation

37
Q

Which hemorrhagic stroke occurs when calm vs during activity

A 
Calm = intracerebral
Activity = subarachnoid
38
Q

What artery is occluded in ocular infarction

A

Central retinal artery or retinal branch of ica

39
Q

Where is primary motor cortex located

A

Precentral gyrus - in front of central sulcus

40
Q

What part of ACA occlusion is well tolerated

A

Stem of ACA proximal to connection with anterior communicating artery because of collateral circulation with contralateral ACA

41
Q

MCC of occlusion of superior division of MCA

A

Embolus

42
Q

Types of ischemic strokes

A

Embolic, thrombotic, lacunae

43
Q

Where are lacunar strokes mainly seen

A

Putamen, pons, thalamus, caudate nucleus, internal capsule

44
Q

Palinopsia

A

Abnormal recurring visual imagery, caused by PCA stroke

45
Q

What kind of aphasia is seen in vertebrobasilar strokes

A

No aphasias or cognitive deficits are seen

46
Q

Presentation of distal ica occlusion:

Arteries involved?

A

ICA branches into MCA, so it may affect all or part of ipsilateral MCA, and part of ACA. Present with contralateral motor and/or sensory symptoms.

47
Q 
Presentation of superior division of MCA stroke:
Motor loss?
Eye deviation?
Aphasia?
Other?
A

Sensory and motor deficits of contralateral face and arm > leg.
Head and eyes deviate toward infarct.
dominant hemisphere - Global aphasia –> broca’s
Nondominant hemisphere - Spatial perception, hemineglect, constructional and dressing apraxia

48
Q

Which division of MCA supplies broca’s area, and which supplies wernicke’s

A 
Superior = broca's
Inferior = wernicke's

Stroke (11 decks)

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