Vascular neurology Flashcards
ipsilateral CN III palsy + contralateral hemiplegia
weber’s syndrome = midbrain lesion
ipsilateral CN III palsy + contralateral involuntary movements
Benedikt’s syndrome = lesion int he ventral portion of the mesencephalic tegmentum, still part of the midbrain
Ipsilateral CN VII palsy + contralateral hemiplegia
millard-gubler syndrome = lesion in the pons
limited upward gaze, convergence retraction nystagmus, light-near dissociation, lid retraction, and skew deviation of the eyes
Parinaud’s syndrome = lesion affection the quadrigeminal plate
vertigo, nystagmus, nausea, decreased gag reflex, hiccups, hoarseness, dysphagia
IPSILATERAL - paralysis of the palate and vocal cord, impaired sensation of the hemiface, ataxia, Horner’s
CONTRALATERAL - loss of sensation to pain + temp in the hemibody
Wallenberg’s syndrome = caused by lateral medullary infarct; a/w PICA or Vert occlusion
IPSILATERAL - hearing loss, vertigo, ataxia, Horner’s, hemiface loss of sensation
CONTRALATERAL - hemibody loss of sensation
AICA infarct
CONTRALATERAL - hemibody sensory loss w/ subsequent pain, allodynia, paresthesias
determine-roussy syndrome = thalamic lesion
finger agnosia, right-left disorientation, agraphia and alcalculia
gerstmann’s syndrome
normal variant with vascular supply to both medial thalami
artery of percheron
deep brach from ACA that supplies anterior limb of the IC, inferior part of head of caudate, anterior part of globus pallidus
recurrent artery of heubner (arises from ACA, specifically A2 segment)
caused by chronic HTN, and a/w pathogenesis of lacunar strokes
lipohyallinosis
infarct b/w 2 vascular territories. produces the “person in a barrel” syndrome, characterized by proximal weakness
watershed infarcts
infarct in the posterior circulation from thrombus lodging in the distal basilar
s/s = behavioral abnormalities, altered level of conscious, abnormalities of ocular motion
top of the basilar syndrome
right hemiparesis, right homonymous hemianopsia, and aphasia
left MCA syndrome
left hemiparesis, left homonymous hemianopsia, left hemineglect
right MCA syndrome
thalamus, contralateral hemisensory loss
pure sensory lacunar syndrome
posterior limb of IC, contralateral motor deficits. also described with ventral pons lacunes
pure motor lacunar syndrome
paramedia pons, clumsy hand and dysarthria
clumsy-hand dysarthria lacunar syndrome
pons, midbrain or IC, weakness with ataxia out of proportion to weakness
ataxic hemiparesis lacunar syndrome
NOTCH 3
CADASIL = cerebral autosomad dominant arteriopathy with subcortical infarcts and leukoencephalopathy
dilated thin-walled vessels, with no smooth muscle or elastic fibers and no intervening brain parenchyma. popcorn appearance on mri
cavernous malformation
thin walled venous structure with normal intervening brain tissue
venous angioma
abnormally dilated capillaries, normal intervening brain tissue
capillary telangiectasia
nidus w/ arteries and veins communication without an intervening normal capillary bed in b/w
ateriovenous malformation
hemorrhage in the putamen, caudate, thalamus, pons, cerebellum and deep white matter
A/w lipohyalinosis & Charcot-bouchard microaneurysyms
hypertensive ICH
lobar hemorrhages
multiple micro hemorrhages on MRI GRE; Congo-red positive amyloid material seen as apple-green birefringence with polarized light
cerebral amyloid angiopathy = CAA
puff of smoke
extensive collateral circulation seen in moyamoya disease, in which there is b/l stenosis of the distal ICA and intracranial arteries of the circle of willis
