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40 Cards in this Set
- Front
- Back
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Cervical Syringomyelia
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(C5-C8)
Dmg Anterior commissure -> Lose pain/temp for upper dermatome Bilateral "Syringes hurt -> no pain(temp)" |
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Loss of pain & temp in upper dermatome bilateral
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Syringomyelia (dmg anterior commissure)
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Posterior spinal artery infarction
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Dmg: fasciculus gracilis & cuneatus -> lose IPSILATERAL conscious prop & tactile sens in UE & LE
Dmg: Lissauer's -> lose IPSILATERAL Pain/Temp Dmg: Dorsal horn -> lose touch IPSILATERAL lose CST (motor) -> IPSILATERAL hemiplegia |
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Hemiplegia w/ Hemianesthesia in: Pain & Temp on same side
Loss of conscious proprioception in upper & lower limbs on same side loss of touch on same side |
Posterior spinal artery infarction - cervical region
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Anterior spinal artery infarction (below T6)
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Dmg: fasciculus gracilis -> lose touch & proprioception in lower limb (cuneatus above T6) BILATERAL
Dmg: Anterior commissure -> lose Pain/temp at level affected BILATERA +/- ALS -> lose Pain/Temp below level BILATERAL +/- CST -> Spastic paralysis (UMN) in lower limbs BILATERAL Ventral horn -> flaccid paralysis of lower limb (and axial) ONLY at level affected BILATERAL |
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Bilateral loss of:
Pain & Temp (at or below level) Spastic paralysis below level Flaccid paralysis at level Loss of touch & conscious proprioception in lower limb bilateral |
anterior spinal artery below T6
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Brown-Sequard Syndrome
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(cord hemisection - C4)
Dmg: Gracilis & Cuneautus -> Lose conscious proprio & touch in UE & LE IPSILATERAL ALS -> Lose Pain/Temp below lesion CONTRALATERAL Dmg: Spinocerebellar tracts -> lose unconscious proprio (some ataxia) IPSILATERAL dmg: CST -> Spastic hemiplegia: UE & LE IPSILATERAL Dmg: Anterior horn -> Flaccid paralysis at level affected IPSILATERAL |
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Hemiplegia of UE & LE w/ contralateral loss of Pain & temp
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Brown-Sequard Syndrome (cord hemisection - at C4)
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Medial Medullary Syndrome (paramedian
Dejerine) Anterior Spinal Artery |
Dmg: Medial Lemniscus -> Contralateral loss of Pain & temp (above decussation)
Dmg: Hypoglossal nucleus (XII) -> flaccid hemi tongue palsy (tongue deviates TOWARD lesion) Dmg: CST -> Hemiplegia (Spastic) iin UE & LE CONTRALATERAL |
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Spastic hemiplegia of UE & LE w/ same side loss of Touch/Proprio
Contralateral Tongue flaccid hemiplegia |
Medial (Paramedia) medullary syndrome (in Medulla Oblongata)
Anterior spinal artery Tongue deviates TOWARD lesion |
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Wallenberg Syndrome
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(aka Lateral Medullary Syndrome) - c/o Proximal PICA (or vertebral)
Dmg: Spinal Trigem Nuc -> IPSILATERAL loss Pain/Temp from face Dmg Vestibular Nuc (near ICP) -> falling (towards lesion), nystagmus, vertigo IPSILATERAL Dmg: ALS -> Loss pain & temp CONTRALATERAL Dmg: Solitary nuc -> IPSILATERAL loss of taste +/- Cochlear nuc -> IPSILATERAL Hearing loss Dmg: Hypothalamo Sympathetics -> Horner's Syndrome IPSILATERAL (Ptosis, miosis, anhydrosis) Dmg: ICP -> Cerebellar ataxia IPSILATERAL Dmg: Nucleus Ambiguus (IX & X) IX: Palate pareses (dysphagia) X: Reduced gag reflex IPSILATERAL +/- Dorsal motor -> IPSILATERAL |
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Loss of Pain & Temp on L Face
falling towards L side, nystagmus, vertigo Loss of pain & temp in R side of BODY Loss of taste on L side of tongue Ptosis, miosis, anhydrosis on L side of face dysphagia |
Lateral Medullary Syndrome (aka Wallenberg's Syndrome)
proximal PICA (or vertebral) "Wally has picked (PICA) medium lats" |
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Tonsillar herniation of Medulla oblongata
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Dmg: Cardiorespiratory centers -> Cardiac arrest & Respiratory arrest BILATERAL
("Death is a bilateral condition") |
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Spastic hemiplegia of UE & LE on L side
L sided Hemianesthesia R sided Flaccid Facial Paralysis R eye adducted, conjugate horizontal gaze dysfunctional |
Medial (Paramedian) Pontine syndrome
Penetrating branches (probably from basilar) |
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Medial (Paramedian) Pontine syndrome
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Dmg CST -> Spastic Hemiplegia of UE & LE CONTRALATERAL
Dmg Abducens -> Ipsilateral Lateral rectus gone (Adducted eye) Dmg VII -> Ipsilateral Upper & lower facial Paralysis Dmg PPRF -> Ipsilateral conjugate gaze gone Dmg ML -> Contralateral Touch & proprio gone |
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Lateral Pontine Syndrome
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AICA (+ Long brs. Of basilar)
Dmg: ALS -> lose CONTRALATERAL pain & temp Dmg: VTT (ventral Trigem Thalamic) -> CONTRALATERAL analgesia (Pain & Temp) of face +/- ML -> lose Touch/Conscious Proprio (lower limb first) on CONTRALATERAL Dmg: Chief Sensory Nuc -> Facial touch & Proprio IPSILATERAL Dmg: Trigem Motor -> IPSILATERAL Masticatory paralysis Dmg MCP (+/- SCP) -> Ataxia IPSILATERAL |
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R sided ataxia
R sided Facial loss of pain & temp R sided mastication paralysis L sided loss of tactile sensation L |
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L side of body loss of Pain & temp
L side of Face loss of Pain & Temp L side of body loss of touch (+/-) R side of Face loss of tactile & proprio R side loss of mastication mm R sided ataxia |
Lateral pontine syndrome on R side
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Basilar thrombosis
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Locked in syndrome
Lose all CST -> Quadriplegia Lose all of CBT (except +/- eye mm) quadriplegia lose V, VI, VII, X -> can't move face, eye, can't swallow BILATERAL |
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Vestibulocerebellum (flocculus & nodulus)
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dizziness, falling (toward lesion), nystagmus, spinning
IPSILATERAL Distal PICA |
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Falling toward R side
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R sided vestibulocerebellar dysfunction (possible, not definite, could also be other parts of R side vestibulosensory)
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Paramedian midbrain syndrome
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(aka Claude's Syndrome) c/o terminal basilar parmedian aa (brs of proximal PCA)
Dmg III -> Down & out eye (primarily ipsilateral) dmg SCP decussation -> Ataxias (skilled ataxias) CONTRALATERAL Dmg Red Nuc. -> Upper limb proximal flexors CONTRALATERAL dmg E-W Nucleus (PS - normally constrict via sphincter pupillae) -> Dilated eye (CN III gone -> primarily ipsilateral mydriasis) |
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L eye down & out & mydriasis
R sided loss of skilled function (skilled ataxia) R sided proximal upper limb flexors paralysis |
Paramedian midbrain syndrome (Claude's Syndrome)
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Cerebral peduncle syndrome
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(aka Weber Syndrome) c/o terminal basilar paramedian aa (br of proximal PCA)
Dmg CST -> CONTRALATERAL hemiplegia Dmg CBT -> Some IPSI some BI-lateral hemiplegia dmg CN III -> Down & out eye (mydriasis too) IPSILATERAL |
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L eye down & out & mydriasis
R sided hemiplegia of body Bilateral facial Hemiplegia (mostly R side) |
Cerebral Peduncle Syndrome (Weber)
C/o terminal basilar Paramedian aa (br of proximal PCA) |
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Medial midbrain syndrome
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(aka Benedikts syndrome = Claude + Weber) "Think of as an expanded medial midbrain syndrome"
+/- Dmg to Red nucleus -> paralysis of CONTRALATERAL upper limb flexors Dmg E-W -> ipsilateral mydriasis dmg CN III -> Down & out eye IPSILATERAL Dmg CST -> CONTRALATERAL hemiplegia "Medial Midbrain = Red III Contra CST" |
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Uncal Herniation (through tentorial notch)
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c/o Supratentorial masses
dmg CN III -> Down & out eye & pupillary dilation IPSI or BI-lateral CST & CBT -> weakness of body muscles & face (IPSI or BI-lateral) "My Uncle Sam eye's weak Face & Body" |
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Bilateral body mm weakness &
Down & out eye L eye w/ mydriasis |
Uncal herniation (possible L or R but more likely L)
"Pirate Uncle: weak lazy eye" |
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Dorsal midbrain syndrome
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(aka Parinaud's Syndrome)
dmg Sup. Colliculus -> difficulty tracking & voluntary saccades BILATERAL Dmg Vertical gaze center -> Initally Upward gaze paralysis progresses to COMPLETE vertical gaze paralysis Dmg Post. Commissure -> impaired Consensual light reflex BILATERAL Dmg Cerebral Aqueduct -> Hydrocephalus (communicating) |
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Upward gaze paralysis w/ difficulty tracking & w/ voluntary saccades
Lack consensual light reflex & possible hydrocephalus |
Dorsal midbrain syndrome (Parinaud's Syndrome)
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Anterior Cerebral artery Syndrome
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(Relatively uncommon relative to MCA & PCA)
Dmg: post-central gyrus -> Lower limb anaesthesia CONTRALATERAL dmg Pre-central gyrus -> lower limb paralysis CONTRALATERAL dmg Micturition center -> reduced voluntary bladder control Dmg Olfactory cortex -> Anosmia Dmg Corpus callosum -> Disconnection syndrome (maybe split brain) |
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Lower limb anesthesia & paralysis on L side w/ reduced bladder control & anosmia
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R sided Anterior Cerebral Artery syndrome
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Posterior cerebral artery dmg
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Dmg Visual cortex -> homonymous heminopia (possible macular sparing) (dmg Primary & Secondary: 18 & 19)
Thalamus -> thalamic syndrome |
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Homonymous heminopia (w/ or w/o macular sparing)
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Dmg to PCA (posterior cerebral artery)
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Middle cerebral artery (superior division)
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Dmg post-central gyrus -> anesthesia of UE & Face (maybe some trunk) CONTRALATERAL
Dmg Insula & operculum -> Taste (agustia) & primary gustatory cortex dmg Pre-central gyrus -> Paralysis of Upper Limbs & face CONTRALATERAL Dmg Brocas -> aphasia (can't speak but can understand) dmg Angular gyrus -> Trouble reading aloud from L visual field (association cortex) Dmg L parietal general -> Acalcula, writing problems |
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Paralysis & anaesthesia of Right UE & face
Loss of taste Aphasia (can't speak but can understand) Trouble reading from L visual field |
L MCA Superior division infarct
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Middle cerebral artery (Inferior division)
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dmg Primary & Secondary Auditory (domninant side: Wernicke's area) -> aphasia (Speech is fluent but non-sensical)
+/- occipital pole -> +/- macular vision Dmg White matter core of temporal lobe (Meyer's loop) -> Upper quandrantanopia (L infarct = R upper Quadrantanopia) |
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L upper quadrantanopia
Fluent but non-sensical speech (aphasia) Possible macular vision loss |
Middle Cerebral Artery (inferior division)
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Middle Cerebral Artery infarct at origin
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Dmg Genu & PLIC & Lentiform nucleus -> Hemiplegia & Hemianesthesia Body & face CONTRALATERAL
Note: motor system (basal nuclei) dysfunction masked by paralysis |
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L side Hemiplegia & Hemianaesthesia of Face & Body
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Infarct of Right MCA at origin
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