Neuro 6.05 - Migraine

Front 1

Eyes deviate towards side of lesion in ______ and away from side of lesion in ________.

Back 1

stroke - eyes go towards side of lesion
seizure - eyes go to side away from side of lesion

Front 2

A lesion to which part fo the brain would cause the following signs:
• Agnosia
– Denial of functional loss
– Face recognition
• Neglect
– Sensory extinction
– Visual inattention/extinction
• Apraxia
– Constructional
– Dressing

Back 2

Non-dominant parietal lobe

Front 3

A lesion to which part of the brain would cause the following signs:
• Gerstmann syndrome
– Left-Right disorientation
– Dyscalculia
– Dysgraphia
– Finger naming
• Apraxia
– Ideomotor
– Ideational

Back 3

Dominant parietal lobe

Front 4

A lesion to which part of the brain would cause the following signs:
• Deficits
– Unable to follow command (may be limited)
– Fluent but meaningless speech
– Appear oblivious of any deficit
• Paraphasias
– Phonemic ‘The cat sat on the mal’
– Semantic ‘The cat sat on the dog’
– Neologism ‘This building is a herpidag’
– Word salad or gibberish

Back 4

Wernicke's area (temporal lobe)

Front 5

A lesion to which part of the brain would cause the following signs:
– Can follow command (may be limited)
– Non-fluent (frustrated) speech
– Limited repertoire (swearing, yes, no)

Back 5

Broca's area (frontal lobe)

Front 6

Back 6

PCA infarct

Front 7

What functional areas would be affected by ischaemia in the ACA-MCA border zone?

Back 7

- Hip, shoulder (less typically arm) region or primary motor or somatosensory cortex
- Areas related to language production (in dominant hemisphere)
- Frontal eye fields
- Frontal lobe motor planning area

Front 8

What functional areas would be affected by ischaemia in the ACA/MCA-PCA border zone?

Back 8

- Optic radiations
- Inferior temporal lobe cortex (important for visual/spacial/facial recognition)
- Language comprehension, word finding in dominant hemisphere
- Parietal lobe visuospatial perceptions

Front 9

Back 9

A. ACA
B. MCA
C. MCA
D. Anterior perforated substance
E. Boundary/watershed of ACA and MCA

Front 10

Back 10

A. ICA
B. Cavernous sinus
C. Superior petrosal sinus
D. Superior sagittal sinus
E. Transverse sinus

Front 11

Back 11

A. Pituitary gland
B. Amygdala
C. Anterior horn of lateral ventricle
D. Hippocampus
E. Cerebral peduncle

Front 12

Back 12

A. Putamen
B. Globus pallidus
C. Thalamus
D. Splenium of corpus callosum

Front 13

Back 13

A. Anterior communicating artery
B. ACA
C. AChA
D. ICA
E. PCA
F. Posterior communicating artery

Front 14

Back 14

A. ACA
B. Internal carotid (siphon)
C. MCA stem
D. AChA (anterior choroidal artery)
E. PCA

Front 15

Back 15

A. PCA
B. Basilar artery
C. Internal carotid
D. Vertebral artery
E. Common carotid artery
F. Subclavian artery

Front 16

Back 16

ACA

Front 17

Back 17

MCA

Front 18

Back 18

PCA

Front 19

What is the normal range of intracranial pressure?

Back 19

0-15 mmHg

Front 20

How are brain tumours diagnosed?

Back 20

- Cranial MRI with contrast injection (if MRI negative, essentially rules out brain tumour)
- Diagnosis must be confirmed by histological examination
- PET can help distinguish high/low grade tumours

Front 21

What cell type do meningiomas arise from?

Back 21

Arachnoid cells

Front 22

How do meningiomas appear on microscopy?

Back 22

Whorls of cells

Front 23

- Loss of ability to accommodate associated with ageing and usually strikes in the 50s
- Major contributor is the loss of lens flexibility so that it cannot change its curvature

Back 23

Presbyopia

Front 24

What is the most common long- term complication (particularly with pediatric cataract surgery)

Back 24

Posterior Capsule opacification (PCO) - epithelial cell proliferation, migration and fibrosis

(Followed by glaucoma and late-age related maculopathy)

Front 25

Is the aura associated with migraine associated with changes in neural firing or changes in blood flow?

Back 25

Neural firing

Front 26

Damage to WHICH cortex can result in the loss of ability to alter response when input changes – decision maker for appropriate movement. It may also result in:
- difficulty going for the big picture; attention only to details.
- They laugh or cry inappropriately
- trouble with working memory – temporary data storage

Back 26

Prefrontal association cortex

Front 27

Extensive damage to WHICH cortex can result in conditions such as:
• finger agnosia (inability to recognize different fingers)
• agraphia (inability to write)
• alexia (inability to read)
• dyscalculia ( decreased ability to calculate or use numbers)
• left-right confusion
• disturbances in the awareness of body image

Back 27

The parietal association cortex

Front 28

Damage to which cortex causes contralateral neglect syndrome?

(Patients bump into objects on contralateral side of lesion
May not groom contralateral body
May not eat food on side opposite to lesion
The patients receive sensory information from the contralateral side of the body but they simply neglect it.)

Back 28

Parietal association cortex

Front 29

Extensive damage to WHICH cortex can result in changes in emotional processing. For example, damage has been reported to result in a patient being able to “feel” and accurately localize painful stimuli but the pain does not bother them.

Back 29

Limbic association cortex

Front 30

How to assess likelihood of stroke after a TIA

Back 30

ABCD2 Score
- Age 60 years or older (1)
- BP elevated on first assessment after TIA (systolic >140, diastolic >90) (1)
- Clinical features of TIA (unilateral weakness = 2, speech impairment without weakness = 1)
- Duration of TIA (>60m = 2, 10-59m = 1)
- Diabetes (1)

Front 31

What is the most likely vascular territory involved in a TIA with left arm and leg weakness and slurring of speech?

Back 31

Right MCA territory