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S4- Neuro 1 > Week 1 Zoom- CVA Clinical Syndromes > Flashcards

Week 1 Zoom- CVA Clinical Syndromes Flashcards

1
Q

PART 1- ANTERIOR CEREBRAL ARTERY

A

PART 1- ANTERIOR CEREBRAL ARTERY

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2
Q

The ACA travels through the __________ fissure.

A

longitudinal

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3
Q
  • The ACA provides blood to the ________ and _______ surface of the brain, from the ______ lobe to anterior _______ lobe.
  • It also supplies the _______ _________.
A
  • anterior and medial, frontal lobe to anterior parietal lobe
  • corpus callosum
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4
Q

What are the signs and symptoms of ACA Syndrome?

A
  • contralateral hemiparesis/hemiplegia LE>UE
  • contralateral hemisensory loss LE>UE
  • Apraxia
  • Problems w/bimanual tasks
  • significant cognitive deficits (agitation memory, emotional lability, motor preservation)
  • lack of spontaneity, motor inaction, slowness and delay (difficulties with executive function tasks)
  • transcortical aphasia
  • contralateral grasp reflex, sucking reflex
  • “Alien hand syndrome”
  • Urinary incontinence
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5
Q

Damage to the medial aspect of the primary motor cortex causes what S/Sx of ACA Syndrome?

A

contralateral hemiparesis/hemiplegia LE>UE

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6
Q

Damage to the medial aspect of the primary sensory cortex causes what S/Sx of ACA Syndrome?

A

contralateral hemisensory loss LE>UE

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7
Q

Damage to the supplemental motor area and corpus callosum causes what S/Sx of ACA Syndrome?

A

apraxia

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8
Q

Damage to the corpus callosum alone causes what S/Sx of ACA Syndrome?

A

problems with bimanual tasks

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9
Q

Damage to the frontal cortex causes what S/Sx of ACA Syndrome?

A

significant cognitive deficits (agitation, memory, emotional lability, motor preservation)

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10
Q

Damage to the pre-frontal cortex causes what S/Sx of ACA Syndrome?

A
  • lack of spontaneity, motor inaction, slowness and delay

- difficulties with executive function tasks

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11
Q

Damage to the dominant hemisphere supplemental motor area causes what S/Sx of ACA Syndrome?

A

transcortical aphasia

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12
Q

Damage to the posteromedial aspect of superior frontal gyrus causes what S/Sx of ACA Syndrome?

A

urinary incontinence

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13
Q

What are the main differences in the presentation of a left ACA vs a right ACA?

A

Left ACA

  • transcortical aphasia may be seen
  • may see apraxia (less common)

Right ACA
-may see L neglect (less common)

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14
Q

PART 2- MIDDLE CEREBRAL ARTERY

A

PART 2- MIDDE CEREBRAL ARTERY

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15
Q

The MCA splits into ________ and _______ branches, that arise from the MCA ______.

A
  • superior and inferior branches

- MCA stem

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16
Q
  • What lobes does the superior MCA branch supply?

- What lobes does the inferior MCA branch supply?

A

Superior

  • lateral and inferior frontal lobe
  • anterior and lateral parietal lobe

Inferior

  • lateral temporal lobe
  • lateral occipital lobe
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17
Q

What are the signs and symptoms of MCA Syndrome?

A
  • contralateral paresis UE/face>LE
  • contralateral sensory loss UE/face>LE
  • motor speech impairment
  • receptive speech impairment
  • global aphasia
  • perceptual deficits: unilateral neglect, depth perception, spatial relations
  • apraxia
  • visual deficits
  • loss of conjugate gaze to opposite side
  • pure motor hemiplegia (lacunar stroke)
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18
Q

What are the main differences in the presentation of a left and right MCA superior division syndrome?

A

Left MCA Superior Division

  • Non-fluent (Broca’s) aphasia
  • apraxia
  • R visual field loss or dysconjugate gaze

Right MCA Superior Division

  • L hemineglect
  • L visual field loss or dysconjugate gaze

Both have arm/face weakness and possible sensory deficits

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19
Q

What are the main differences in the presentation of a left and right MCA inferior division syndrome?

A

Left MCA Inferior Division

  • Fluent (Wernicke’s) aphasia
  • R visual field loss

Right MCA Inferior Division

  • L visual field loss
  • profound L hemineglect and other perceptual deficits

Both have arm/face sensory deficits and possible weakness

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20
Q

How will a right/left MCA deep territory syndrome present?

A

contralateral pure motor hemiparesis

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21
Q

What are the main differences in the presentation of a left and right MCA stem syndrome?

A

Left MCA Stem
-global aphasia

Right MCA Stem
-L hemineglect and other perceptual deficits

Both have arm/face weakness/sensory deficits as well as visual field loss and dysconjugate gaze

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22
Q

PART 3- POSTERIOR CEREBRAL ARTERY

A

PART 3- POSTERIOR CEREBRAL ARTERY

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23
Q

The PCA branches off the vertebrobasilir arteries and supplies the ________ lobe and ___________ __________ lobe.

A

-occipital lobe and posteromedial temporal lobes

24
Q

What are the signs and symptoms of PCA syndrome?

A
  • contralateral homonymous hemianopsia
  • cortical blindness
  • visual agnosia
  • prosopagnosia
  • dyslexia
  • memory deficit
  • topographic disorientation
25
Q

Damage to the primary visual cortex or optic radiation causes what S/Sx of PCA Syndrome?

A

contralateral homonymous hemianopsia

26
Q

Damage to bilateral occipital lobes causes what S/Sx of PCA Syndrome?

A

cortical blindness

27
Q

Damage to the occipital lobe (dominant side) causes what S/Sx of PCA Syndrome?

A

visual agnosia

28
Q

Damage to the visual association cortex causes what S/Sx of PCA Syndrome?

A

prosopagnosia

29
Q

Damage to the dominant calcarine and posterior part of corpus callosum causes what S/Sx of PCA Syndrome?

A

dyslexia

30
Q

Damage to the inferomedial portions of the temporal lobe (dominant side) causes what S/Sx of PCA Syndrome?

A

memory deficit

31
Q

Damage to the nondominant primary visual cortex causes what S/Sx of PCA Syndrome?

A

topographical disorientation

32
Q

What are the main differences in the presentation of a left and right PCA Syndrome?

A

Left PCA Syndrome

  • R homonymous hemianopia
  • memory deficits
  • visual agnosia, prosopagnosia

Right PCA Syndrome

  • L homonymous hemoanopia
  • topographical disorientation
33
Q

PART 4- SUPERIOR CEREBELLAR ARTERY SYNDROME

A

PART 4- SUPERIOR CEREBELLAR ARTERY SYNDROME

34
Q

What are the 2 overarching S/Sx of Superior Cerebellar Artery Syndrome?

A
  • Ipsilateral cerebellar symptoms

- Horner’s Syndrome

35
Q

What are the cerebellar symptoms of Superior Cerebellar Artery Syndrome?

A

-cerebellar ataxia
-dizziness
0horizontal nystagmus
-dysconjugate gaze

36
Q

What are the symptoms of Horner’s Syndrome?

A
  • Ptosis (drooping eyelid)
  • Miosis (pupil constriction)
  • Anhidrosis (decreased sweating)
  • Enophthalmos
  • ipsilateral dorsal column loss, contralateral spinothalamic loss
  • dysphagia, dysphonia
37
Q

PART 5- MEDIAL MEDULLARY SYNDROME

A

PART 5- MEDIAL MEDULLARY SYNDROME

38
Q

Medial Medullary Syndrome involves occlusion to _______ _________ artery or medial medullary branches of the __________ artery.

A
  • anterior spinal

- vertebral

39
Q

What are the 4 M’s of areas affected by Medial Medullary Syndrome?

A
  • Motor pathway of (corticospinal tract)
  • Medial lemniscus
  • Medial longitudinal fasciculus
  • Motor pathway of (hypoglossal nerve)
40
Q

What are the S/Sx of Medial Medullary Syndrome?

A
  • contralateral UE/LE hemiparesis
  • contralateral loss of discriminative touch, vibratory and proprioception sense on body
  • ipsilateral internuclear ophthalmoplegia (failure of adduction of ipsilateral eye towards nose i.e. CN III function and nystagmus in the opposite eye as it looks laterally i.e. CN VI)
  • ipsilateral paralysis of tongue with tongue deviation on protrusion towards affected side
41
Q

PART 6- LATERAL MEDULLARY SYNDROME (WALLENBURG’S SYNDROME)

A

PART 6- LATERAL MEDULLARY SYNDROME (WALLENBURG’S SYNDROME)

42
Q

Lateral Medullary Syndrome involves occlusion of the _________ _________ _________ artery or _________ artery.

A
  • posterior inferior cerebellar

- vertebral

43
Q

What are the key areas affected by Lateral Medullary Syndrome?

A

medulla oblongata, choroid plexus of 4th ventricle, dentate nucleus, main supplier of blood to cerebellum

44
Q

What are the S/Sx of Lateral Medullary Syndrome?

A
  • vertigo
  • N/V
  • nystagmus
  • ataxia
  • balance and gait coordination problems
  • ipsilateral facial pain/temp loss
  • contralateral body pain/temp loss
45
Q

PART 7- MEDIAL INFERIOR PONTINE SYNDROME

A

PART 7- MEDIAL INFERIOR PONTINE SYNDROME

46
Q

Medial Inferior Pontine Syndrome involves occlusion of the paramedian branch of the ________ artery.

A

basilar

47
Q

What are the key areas affected by Medial Inferior Pontine Syndrome?

A

CN VI nucleus, medial lemniscus, pontine center, vestibular nuclei, middle cerebellar peduncle, CST and corticobulbar tracts

48
Q

What are the S/Sx of Medial Inferior Pontine Syndrome?

A
  • ipsilateral dysconjugate gaze
  • ipsilateral nystagmus
  • ipsilateral diplopia on lateral gaze
  • ipsilateral paresis of face
  • contralateral paresis of UE and LE
  • contralateral tactile and proprioception
49
Q

PART 8- LATERAL INFERIOR PONTINE SYNDROME

A

PART 8- LATERAL INFERIOR PONTINE SYNDROME

50
Q

Lateral Inferior Pontine Syndrome involves occlusion of the ________ _______ __________ artery, branch of the __________ artery.

A
  • anterior inferior cerebellar

- basilar

51
Q

What are the key areas affected by Lateral Inferior Pontine Syndrome?

A

-CNV (sensory), VII, and VIII nuclei, pontine center, middle cerebral peduncle, cerebellar hemisphere

52
Q

What are the S/Sx of Lateral Inferior Pontine Syndrome?

A
  • nystagmus
  • vertigo
  • N/V
  • ipsilateral facial paralysis and sensory loss
  • ipsilateral dysconjugate gaze
  • hearing loss
  • ataxia
  • contralateral pain/temp loss of body
53
Q

PART 9- LOCKED IN SYNDROME

A

PART (- LOCKED IN SYNDROME

54
Q

Locked In Syndrome involves occlusion of the _______ artery leading to bilateral ventral pontine infarct.

A

basilar

55
Q

What are the S/Sx of Locked In Syndrome?

A
  • acute hemiparesis that progresses to full body tetraplegia
  • lower bulbar paralysis (4-12 involvement)(upward eye movements and blinking only thing spared)
  • mutism (loss of voice)
  • cognition is spared

S4- Neuro 1 (12 decks)

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