Vasculature

Question 1

PICA

Answer 1

• lateral area of medulla
• ALS
• Nucleus Ambiguus
• spinal trigeminal tract (loss of pain and thermal sensations from the ipsilateral side of the face)
• spinal trigeminal nucleus

Question 2

Superior Cerebellar Artery

Answer 2

• involved in trigeminal neuralgia
• supplies superior cerebellum and cerebellar nuclei
• midbrain
• principal sensory nucleus (along with circumfrential branches of basilar artery)

Question 3

AICA

Answer 3

• may compress on facial N and cause hemifacial spasms

- supplies lateral and inferior cerebellum, pons

Question 4

Labyrinthine

Answer 4

• branch of AICA

- serves inner ear

Question 5

Posterior Spinal Artery

Answer 5

-supplies posterior columns and nuclei in medulla

Question 6

Anterior Spinal Artery

Answer 6

-pyramid, medial lemniscus, and exiting roots of the hypoglossal nerve

Question 7

Quadrigeminal Artery

Answer 7

supplies anterolateral system and the medial lemniscus in lateral portions of the midbrain

Question 8

Epidural Hematoma

Answer 8

• bleed between dura mater and skull
• typically caused by head trauma that breaks temporal bone and causes bleeding from middle meningeal artery
• accumulated blood can compress oculomotor nerve = dilated pupil on side of injury
• eye will be positioned down and out due to unopposed innervation of trochlear and abducens
• weakness of extremities on opposite side of lesion due to compression of the crossed pyramid pathways
• vision loss on opposite side due to compression of posterior cerebral artery

Question 9

Subarachnoid Hemorrhage

Answer 9

• “star-shaped” bleed at base of brain
• bleed between arachnoid and pia layers
• usually ruptured cerebral aneurysm - ICA and MCA
• neck pain common
• thunderclap HA

Question 10

Thrombosis

Answer 10

• white spot on imaging; white area is resulting ischemiaa of supplied area
• diminished perfusion of one area can cause hyperperfusion of adjacent artery to watershed area and localized cerebral edema
• deficits associated with edema and ischemia
• for sinus thrombosis: sx of post-nasal drip, scalp edema and venous distention because venous blood flows readily from scalp veins to dural venous sinuses
• cavernous sinus thrombosis

Question 11

Subdural Hematoma

Answer 11

• imaging shows significant midline subfalcine shift
• blood gathers between the inner layer of the dura mater and the arachnoid mater
• usually from tears in bridging veins crossing the subdural space vs tears in arteries (epidural hematoma)
• signs/sx slower onset than epidural hematoma
• increased intercranial pressure/volume

Question 12

Vertebral Basilar Insufficiency

Answer 12

-poor blood flow to posterior brain

secondary to subclavian steal syndrome or cervicomandibular fx

Question 13

Anterior Cerebral A

Answer 13

Branches: internal capsule, corpus striatum, globus pallidus, putamen, caudate
Cortex: antero - medial frontal, ant cingulate gyrus, paracentral lobule

Question 14

Middle Cerebral

Answer 14

Branches: thalamostriate arteries to internal capsule, thalamus, corpus striatum
Cortex: primary motor, pre-motor, Broca, Wernicke, primary auditory

Question 15

Posterior Communicating A

Answer 15

internal capsule, basal ganglia

Question 16

Posterior Cerebral A

Answer 16

primary visual cortex

Question 17

Basilar A

Answer 17

median and lateral pons

Question 18

Superior Cerebellar A

Answer 18

Branches: deep cerebellar nuclei, upper pons, midbrain
Cortex: superior lateral cerebellum