First Aid: Brain Lesions

Front 1

Kluver Bucy

Back 1

Bilateral amygdala

Front 2

Disinhibition and judgement deficits

Back 2

Frontal lobe

Front 3

Spacial neglect syndrome

Back 3

Right parietal lobe

Front 4

Agraphyia, acalculia, finger agnosia, and L-R disorientation

Back 4

Left parietal lobe at angular gyrus

Front 5

Reduced level of arousal

Back 5

Reticular activating system

Front 6

Wernicke-Korsakoff (confusion, ataxia, memory loss, personality changes, and confabulation

Back 6

Bilateral mammillary bodies

Front 7

Tremor, chorea, or athetosis

Back 7

Basal ganglia

Front 8

Intention tremor, limb ataxia with fall towards side of lesion

Back 8

Ipsilateral Cerebellar hemisphere

Front 9

Truncal ataxia, dysarthria

Back 9

cerebellar vermis

Front 10

contralateral hemiballismus

Back 10

subtalamic nucleus

Front 11

Anterograde amnesia (can't make new memories)

Back 11

Hippocampus

Front 12

Eyes look away from side of lesion

Back 12

PPRF

Front 13

Eyes look towards lesion

Back 13

Frontal eye fields

Front 14

Paralysis of upward gaze

Back 14

Suprior colliculi

Front 15

Acute paralysis, dysarthria, dysphagia, and LOC in a hospitalized hyponatremic patient

Back 15

Osmotic demylination of the central pontine due to rapid correction of hyponatremia

Front 16

Broca's or Wernicke's aphasia

Back 16

Left temporal lesion (broca = inferior frontal gyrus, wernicke's = superior temporal gyrus)
Nondominant lesion = can't express or comprehend emotion

Front 17

Poor repetition but fluent speech and intact comprehension

Back 17

Arcuate fasciculus

Front 18

Artery injured if: contralateral hemiparesis and decreased proprioception + ipsilateral tongue paresis

Back 18

Anterior spinal artery = medial medullary syndrome

Front 19

Artery injured if:
contralateral pain and temp
ipsilateral horner's, ataxia, nystagmus, vomitting, facial pain/temp

Back 19

PICA
Lateral medullary/Wallenberg's

Front 20

Artery injured if: Ipsilateral facial paralysis, pain and temp, and dystaxia

Back 20

AICA
Lateral inferior pontine syndrome

Front 21

Artery injured if: Contralateral homonymous hemiopia with macular sparing

Back 21

Posterior cerebral

Front 22

Artery injured if: Contralateral face and arm paralysis and sensory loss with either aphasia (if dominant) or spacial neglect

Back 22

Middle cerebral

Front 23

Artery injured if: Leg/foot motor and sensory deficits

Back 23

Anterior cerebral

Front 24

Artery injured if: CN III palsy (eyes look down and out)

Back 24

Posterior communicating artery

Front 25

Artery injured if: Pure motor hemiparesis

Back 25

Lateral striate ("arteries of stroke") to the internal capsule

Front 26

Locked in syndrome (CN III intact)

Back 26

basilar artery (ventral pons)

Front 27

Where are the watershed areas typically affected with hypotension?

Back 27

Get wedge shaped infarcts in hippocampus, neocortex, and purkinje cells of the cerebellum = extremity weakness and higher-order processing deficits

Front 28

Type of stroke that = pure motor of pure sensory deficits?

Back 28

Lacunar stroke = small arterioles due to lipohyalinosis and atherosclerosis (secondary to htn)

Front 29

Spinal cord lesion if: flaccid paralysis

Back 29

Anterior horn destruction (LMN) = polio or Werdnig-Hoffman

Front 30

Spinal cord lesion if: scanning speech, intention tremor, and nystagmus

Back 30

Random, asymmetric demyelinating lesions = MS

Front 31

Spinal cord lesion if: both UMN and LMN signs without sensory or cognitive deficits

Back 31

Anterior horns and lateral columns = ALS (SOD defect or betel nuts)
(dots at ant horns and lateral to posterior)

Front 32

Spinal cord lesion if: complete occlusion of the anterior spinal artery

Back 32

All lesioned by dorsal columns and tract of lissauer = UMN and LMN signs with intact sensory
(everything but between post horns)

Front 33

Spinal cord lesion if: impaired proprioception that leads to locomotor ataxia

Back 33

Degeneration of the dorsal roots and columns = Tabes dorsalis of tertiary syphillis
(between post horns)

Front 34

Spinal cord lesion if: bilateral loss of pain and temperature (usually in the upper extremities)

Back 34

Syringomyelia = anterior white commisure of spinothalamic tract damaged - seen with Arnold Chiari II
(dot between anterior horns)

Front 35

Spinal cord lesion if: ataxic gait, hyperreflexia, and impaired position and vibration sense

Back 35

Dorsal columns and lateral corticospinal tracts = B12/E deficiency or Friedreich's ataxia
(between post horns and dots lateral to post horns)

Front 36

Spinal cord lesion if:
1. ipsilateral UMN and proprioception loss
2. contralateral pain and temp
3. ipsilateral loss of all sensation at level of lesion with LMN signs

Back 36

Hemisection of the spinal cord = Brown-Sequard syndrome

Front 37

Ipsilateral medial rectus palsy on adduction with nystagmus in abducting eye but normal convergence

Back 37

Medial longitudinal fasiculus = "intranuclear opthalmoplegia" (often seen in MS)

Front 38

Bitemporal hemianopia

Back 38

Optic chiasm

Front 39

Upper quadrant anopia

Back 39

contralateral temporal lesion (MCA)

Front 40

Lower quadrant anopia

Back 40

contralateral parietal lesion (MCA)

Front 41

Homonymous hemianopia

Back 41

Contralateral optic tract lesion

Front 42

Central scotoma

Back 42

macular degeneration