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Neuro Test #1 > Vascular Syndroms/Lesions > Flashcards

Vascular Syndroms/Lesions Flashcards

1
Q

Acute central cervical spinal cord syndrome

A

occlusion of the anterior spinal artery
bilateral paresis or flaccid paralysis of UE, hyperactive reflexes (lateral corticospinal tracts/ventral gray horns)
irregular loss of pain/temp bilaterally over body below lesion (ALS)

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2
Q

thrombosis of anterior spinal artery

A

bilateral flaccid paraplegia or quadriplegia
urinary retention
loss of pain/temp sensation
hyperactive reflexes and Babinski reflexes
paralysis of respiratory muscles at high cervical levels

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3
Q

Foix-Alajouanine syndrome

A

inflammation of spinal veins that results in infarct of spinal cord and necrotic myelitis
ascending pain and flaccid paralysis

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4
Q

spinal AVM symptoms

A

micturition problems
motor deficits
lower back pain

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5
Q

Brown-Sequard syndrome

A

functional hemisection of the spinal cord
contralateral loss of pain/temp sensation (ALS)
ipsilateral loss of discriminative touch/proprioception (dorsal column)
ipsilateral paralysis below lesion (lateral corticospinal fibers

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6
Q

syringomyelia

A

cavitation in central region of spinal cord
bilateral loss of pain/temp sensation - usually cape-like distribution (anterior white commissure)
lower motor neuron deficit - unilateral or bilateral paralysis of UE (spinal motor neuron damage)

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7
Q

medial medullary syndrome

A

occlusion of anterior spinal artery
contralateral hemiplesia of UE, trunk, and LE (pyramids)
contralateral loss of position sense, vibratory sense, and discriminatory touch (ML)
deviation of tongue to ipsilateral side (hypoglossal nerve/nucleus)

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8
Q

lateral medullary syndrome (Wallenburg)

A

occlusion of PICA
contralateral loss of pain/temp (ALS)
ipsilateral loss of pain/temp on face (spinal trigeminal tract and nucleus)
dysphagia, soft palate paralysis, hoarseness, diminished gag reflex (nucleus ambiguous)
ipsilateral Horner syndromd - miosis, ptosis, anhydrosis (descending hypothalamic fibers)
vestibular problems - nausea, diplopia, fall to ipsilateral side, nystagmus (vestibular nuclei)
ataxis to ipsilateral side (restiform body and spinocerebellar fibers)

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9
Q

tonsilar herniation

A

herniation of cerebellar tonsil down through foramen magnum - compresses medulla
sudden respiratory and cardiac arrest (damage to respiratory and cardiac centers)

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10
Q

syringobulbia

A

weakness of tongue muscles (hypoglossal nucleus/nerve)
weakness of pharyngeal, palatal, and vocal musculature (ambiguus nucleus)
nystagmus (vestibular nuclei)
loss of pain/temp on ipsilateral face (spinal trigeminal tract and nucleus/crossing ventral trigeminothalamic fibers)

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11
Q

Medial pontine syndrome

A

occlusion of paramedian branches of basilar
contralateral hemiplesia (corticospinal fibers in basilar pons)
contralateral loss of position/vibratory sense/discriminative touch (medial lemniscus)
ipsilateral lateral rectus paralysis (abducens nerve/nucleus)
paralysis of conjugate gaze toward lesion (PPRF)

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12
Q

lateral pontine syndrome

A

occlusion of long circumferential branch of basilar
ataxia, unsteady gate, fall toward lesion side (middle and superior cerebellar peduncle)
vertigo, nausea, nystagmus, deafness, tinnitus (vestibular and cochlear nuclei/nerves)
ipsilateral paralysis of facial muscles (facial motor nucleus)
ipsilateral paralysis of masticatory muscles (trigeminal motor nucleus)
ipsilateral Horner syndrome (descendin ghypothalamic fibers)
contralateral loss of pain/temp sensation (ALS)
ipsilateral loss of pain/temp from face (spinal trigeminal tract and nucleus)
paralysis of conjugate horizontal gaze (PPRF)

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13
Q

medial midbrain (Weber) syndrome

A 
occlusion of paramedial branch of PCA
contralateral hemiplesia (corticospinal fibers in crus cerebri)
ipsilateral paralysis of eye movements, down and out eye, fixed and dilated pupil (oculomotor nerve)
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14
Q

central midbrain lesion (Claude) syndrome

A

ipsilateral paralysis of eye movement, eye down and out, pupil fixed and dilated (oculomotor nerve)
contralateral ataxis and tremor of cerebellar origin (red nucleus and cerebrothalamic fibers)

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15
Q

Benedikt Syndrome

A

lesion of the midbrain involving both medial (weber) and central (claude) syndromes

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16
Q

Parinaud Syndrome

A

caused by a tumor in the pineal region
paralysis of upward gaze (superior colliculi), hydrocephalus (occlusion of cerebral aqueduct), failure of eye movement (trochlear and oculomotor nn), nystagmus (MLF)

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17
Q

uncal herniation

A

extrusion of the uncus through the tentorial notch
ipsilateral oculomotor palsy - pupils fully dilated, weakness of eye movements (oculomotor nerve)
contralateral hemiplesia (crus cerebri)

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18
Q

Kernohan syndrome

A

oculomotor palsy and hemiplesia of UE and LE both on the same side of the body (oculomotor nerve damaged on ipsilateral side, which crus cerebri on the contralateral side is impaled against the edge of the tentorium cerebelli)

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19
Q

decorticate rigidity (due to supratentorial lesions)

A

flexion of forearm, wrist, and fingers with adduction of UE; extension of LE with internal rotation and plantar flexion of foot)

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20
Q

decerebrate rigidity (due to infratentorial lesions)

A

UE and LE extended, toes pointed inward, forearm pronated, and head and neck extended - opisthotonos

21
Q

bilateral paresis or flaccid paralysis of UE

A

medial portions of both lateral coritospinal tracts; ventral gray horns at cervical levels

22
Q

loss of pain/temp sensation bilaterally over body below lesion

A

ALS in spinal cord

23
Q

contralateral hemiplesia of UE, trunk and LE

A

pyramid/corticospinal fibers

24
Q

contralateral loss of position sense, vibratory sense and discriminative touch

A

medial lemniscus

25
Q

deviation of tongue to ipsilateral side when protruded

A

hypoglossal nerve in medulla or hypoglossal nucleus

26
Q

contralateral loss of pain/temp sense on body

A

ALS

27
Q

ipsilateral loss of pain/temp sense on face

A

spinal trigeminal tract and nucleus

28
Q

dysphagia, soft palate paralysis hoarseness, diminished gag reflex

A

nucleus ambiguus, roots of IX and X

29
Q

ipsilateral Horner syndrome (miosis, ptosis, anhidrosis, flushing of face)

A

descending hypothalamospinal fibers

30
Q

nausea, diplopia, tendency to fall to ipsilateral side, nystagmus, vertigo

A

vestibular nucleus (mainly inferior and medial)

31
Q

ataxia to the ipsilateral side

A

restiform body and spinocerebellar fibers

32
Q

ipsilateral lateral rectus muscle paralysis

A

abducens nerve fibers or nucleus

33
Q

paralysis of conjugate gaze toward side of lesion

A

paramedian pontine reticular formation (PPRF)

34
Q

ataxia, unsteady gait, fall toward side of lesion

A

middle and superior cerebellar peduncles

35
Q

vertigo, nausea, nystagmus, deafness, tinnitus, vomiting

A

vestibular and cochlear nerves and nuclei

36
Q

ipsilateral paralysis of facial muscles

A

facial motor nucleus

37
Q

ipsilateral paralysis of masticatory muscles

A

trigeminal motor nucleus

38
Q

ipsilateral paralysis of eye movement; eye oriented down and out and pupil dilated and fixed

A

oculomotor nerve

39
Q

contralateral ataxia and tremor of cerebellar origin

A

red nucleus and cerebellothalamic fibers

40
Q

lesions of the subthalamic nucleus

A

hemiballismus - rapid and unpredictable flailing movements of the contralateral extremities

41
Q

occlusion of lenticulostriate branches to internal capsule

A 
contralateral hemiplegia (corticospinal fibers)
loss/diminution of sensory perception (thalamocortical fibers traversing posterior limb to sensor cortex)
42
Q

infarction of posterior thalamic nuclei

A

contralateral complete sensory loss (posterior thalamic regions)

43
Q

occlusion of distal branches of A- or M- CA

A

motor and sensory losses in contralateral foot, leg and thigh (damage to the a and p paracentral gyri)
- if it spares the leg and foot, it’s the MCA

44
Q

anterior watershed infarct (ACA-MCA junction)

A

contralateral hemiparesis and expressive language or behavior changes

45
Q

posterior watershed infarct (MCA-PCA junction)

A

visual deficits and language problems

46
Q

anterior choroidal artery syndrome

A

contralateral homonymous hemianopia (optic tract)
contralateral hemiplegia (corticospinal fibers at transition of internal capsule into the crus cerebri)
hemianesthesia on the same side as the hemiplegia (if thalamocortical fibers from VPL to somatosensory cortex are also damaged)

47
Q

Parkinson’s disease

A

loss of dopamine-containing cells in substantia nigra

stooped posture, resting tremor, rigidity, shuffling or festinating gate, difficulty initating or maintaining movement

48
Q

anterior choroidal artery syndrome

A 
contralateral hemiplesia (crus cerebri)
contralateral hemianopia (optic tract damage)

Neuro Test #1 (4 decks)

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