Vasculature of Brain

Question 1

Posterior cord syndrome

Answer 1

Posterior spinal artery clot, loss of propioception in limbs

Question 2

Anterior cord syndrome

Answer 2

Muscle weakness both sides, loss of pain and temperature sensation below level of occlusion

Question 3

Batson’s plexus

Answer 3

Network of veins that connect internal vertebral venous plexuses with deep pelvic and thoracic veins. Valveless network, can help cancer metastasis or spread of infection

Question 4

What artery can give collateral circulation to ICA in the case of slow thrombosis?

Answer 4

External carotid artery through the orbit

Question 5

What are the two types of branches of blood vessels in the brain?

Answer 5

1. Cortical or circumferential branches
2. Cenral (ganglionic or perforating) branches

Question 6

Watershed areas

Answer 6

Borders between two arteries, higher risk of decreased blood flow and cause INFARCTION

Question 7

Lacunar infarction

Answer 7

Loss of blood due to high pressure, can cause lacunae or small cavities in the brain

Question 8

Ruptured circumferential or cortical branches of arteries can cause

Answer 8

Subarachnoid hemorrhage

Question 9

Intracerebral hemorrhage can occur from rupture of

Answer 9

Central or ganglionic or perforating branches of cranial arteries

Question 10

Subarachnoid segment of the ICA branches

Answer 10

1. Opthalmic
2. Posterior communicating
3. Anterior choroidal
4. Anterior cerebral
5. Middle cerebral artery

Question 11

Amaurosis fugax

Answer 11

Painless transient loss of monocular visual loss due to transient ischemic attack (TIA) of the opthalmic artery.

Question 12

Ipsilateral CN III palsy can be caused by

Answer 12

1. Posterior communicating artery aneurysm
2. Midbrain lesion e.g. pinealoma

Question 13

Anterior choroidal artery occlusion

Answer 13

Stroke: contralateral hemiparesis (post. limb of internal capsule), hemianesthesia, homonymous hemianopia (optic tract)

Question 14

Medial striate artery (Recurrent artery of Heubner)

Answer 14

Central branches of anterior cerebral artery, supplies
1. Head of caudate nucleus
2. Putamen
3. Ant. limb of internal capsule

Question 15

Stroke of anterior cerebral artery after ant. communicating artery (A2)

Answer 15

Paralysis and anesthesia of contralateral leg (ant. paracentral gyrus)

Question 16

Lateral striate (lenticulostriate) arteries

Answer 16

Central branches of middle cerebral artery, supplies lenticular nuclei and all of the internal capsule.

Question 17

Lenticulostriate a. stroke

Answer 17

Contralateral hemiparesis, hemianesthesia, UMN facial palsy (genu of int. capsule)

Question 18

Stroke of middle cerebral artery

Answer 18

Paralysis & anesthesia of contralateral face and arm
* Global aphasia if in dominant hemisphere, and hemispatial neglect if in nondominant hemisphere

Question 19

PICA supplies

Answer 19

Dorsolateral part of medulla, cerebellum

Question 20

Wallenburg syndrome (Lateral medullary)

Answer 20

PICA stroke
Alternating hemianesthesia, Horner’s syndrome, vertigo, nystagmus, ataxia, dysphagia, hoarseness of voice

Question 21

Long circumferential branches of the basilar artery

Answer 21

Internal auditory (85% from AICA)
AICA
SCA superior cerebellar a.
PCA posterior cerebral a.

Question 22

AICA supplies

Answer 22

dorsolateral caudal pons, anteroinferior cerebellum

Question 23

SCA supplies

Answer 23

dorsolateral rostral pons, superior cerebellum

Question 24

Posterior cerebral a. supplies

Answer 24

Central branches to thalamus and subthalamus, midbrain, posterior choroidal artery

Question 25

PCA stroke

Answer 25

Thalamus: contralateral hemianesthesia –> thalamic pain
Subthalamus: contralateral hemiballismus
Midbrain or Weber’s syndrome: contralateral hemiparesis + ipsilateral CN III palsy

Question 26

Weber’s syndrome

Answer 26

occlusion of midbrain portion of PCA

Question 27

Cortical branches of PCA stroke

Answer 27

Contralateral homononymous hemianopia with macular sparing

Question 28

Fracture at pterion clinical characteristics

Answer 28

Epidural hematoma
1. Lucid interval
2. Uncal herniation

Question 29

Cerebral venous sinus thrombosis clinical signs

Answer 29

Slow progress, headache, vomiting, seizure, coma

Question 30

Cavernous sinus thrombophlebitis clinical signs

Answer 30

Fever, chemosis, proptosis (eye seems to protrude out), ptosis, diplopia, total ophthalmoplegia (cannot move eye), carotid-cavernous fistula

Question 31

Superficial/external/cortical cerebral vein in the central sulcus

Answer 31

Superior anastomotic vein of Trolard

Question 32

Superficial/external/cortical cerebral vein in the lateral sulcus

Answer 32

Superficial middle cerebral vein of Sylvian

Question 33

Cavernous sinus contents

Answer 33

ICA, CN III, CNIV, CNVI (adjacent to ICA), CN V1 (ophthalmic), CN V2 (maxillary)

Question 34

Inferior anastomotic vein of Labbe

Answer 34

connects Trolard’s and Sylvian’s superficial cerebral veins

Question 35

Rupture of which vessels cause subdural hematoma

Answer 35

Superior cerebral or bridging veins

Question 36

Epidural hematoma is caused by

Answer 36

Middle meningeal artery rupture (Pterion fracture)

Question 37

Internal cerebral veins

Answer 37

Roof of 3rd ventricle

Question 38

Great cerebral vein gets blood from (tributaries of great cerebral vein)

Answer 38

1. Internal cerebral vein
2. Basal veins of Rosenthal

Question 39

Basal veins of Rosenthal

Answer 39

Pinches the midbrain between them