Neuro - Cva By Location

Front 1

• Which artery is most often occluded 2º vascular disease?
  
• What does this artery supply?
  
• Is CVA in this artery typically embolic or thrombic?

Back 1

• MCA
• Lateral surface of brain, BG, portions of internal capsule
• Embolic

Front 2

Effects of MCA occlusion

Back 2

• Contra spastic hemiparesis
• Contra hemiparesthesia
• Contra homonymous hemianopsia
• Contra conjugate gaze impairment

• Global aphasia (L-sided lesion) or anosagnosia (unawareness of issue; R side)

Front 3

• What functions may be affected by MCA upper division occlusion?

Back 3

• Contra brachial syndrome (hemiplegia, face + UE > LE)
• Broca's Aphasia (dominant) or contra hemineglect (non-dominant)

Front 4

Describe Broca's aphasia (expressive aphasia)

Back 4

• Good comprehension
• Difficulty finding words they want to say
• Slow, uneven flow
• Meaningful context words
• Aware of communication difficulty
• tono tono

Front 5

What functions may be affected by language-dominant (usu. L) MCA lower division occlusion?

Back 5

• Wernicke's aphasia

Front 6

Describe Wernicke's aphasia (receptive aphasia)

Back 6

• Able to hear, but difficulty comprehending meaning
• Word choice gives sentences no meaning
• Speech is fluent, with proper pronunciation and grammar
• Alexia + agraphia
• Unaware of poor comprehension or nonsense speech

Front 7

What functions may be affected by non-language-dominant (usu. R) MCA lower division occlusion?

Back 7

Either pure hemiparesis or spatial agnosia (hemineglect), but not both

Front 8

• What functions may be affected by ACA Syndrome (results from ACA occlusion)?
• Anything special to note?

Back 8

• Contralateral paresis & sensory loss, LE + Perineum moreso than UE

• Abulia/kinetic mutism (disorders of motivation)
• Reduced rate/complexity of speech if language-dominant side
• NOTE - rare; often asymptomatic (good collaterals)

Front 9

• What functions may be affected by ICA Syndrome (results from ICA occlusion, hypoxia such as near drowning)
  
• Anything special to note?

Back 9

• Transient monocular blindness (aka amaurosis fugix) due to diminished ocular blood supply
• MCA syndrome common as well (due to MCA being continuation of ICA)
• Complete blockage leads to both ACA and MCA syndromes
• NOTE - often preceded by multiple TIAs
  

Front 10

With a central PCA lesion, what 3 structures are primarily affected?

Back 10

• Subthalamic Nuclei
• Medial Thalamus
• Ipsilateral Cerebral Peduncle

Front 11

What functions may be affected by central PCA Syndrome (resulting from PCA occlusion)?

Back 11

• Thalamic Pain Syndrome (typically 1 mo. of sensory recovery, then intractable pain)
• Hemiballismus (flinging, flailing movements of one extremity due to STN infarct)
• Contra-hemi (due to cerebral peduncle involvement)

Front 12

What functions may be affected by peripheral PCA Syndrome (resulting from PCA occlusion)?

Back 12

• Transient Global Amnesia (TGA) due to hippocampus involvement
• Alexia w/o agraphia
• Cortical blindness & homonymous hemianopsia

Front 13

• Which artery supplies the medulla and posterior/inferior cerebellum?
  
• What might occlusion of this artery cause?

Back 13

• Vertebral arteries
  

• Wallenberg's Syndrome

Front 14

What are three geneses of vertebral artery syndrome?

Back 14

• Atherosclerosis
• Trauma such as MVA
• Iatrogenically, due to inappropriate cervical extension/rotation manipulations

Front 15

What are six functions regulated by the medulla?

Back 15

1. Breathing
2. Heart rate
3. Blood vessel function
4. Digestion
5. Sneezing
6. Swallowing

Front 16

What are the diagnostic signs of Wallenberg's Syndrome? What are the causes?

Back 16

• Contralateral pain/temperature loss of body (spinothalamic tract involvement)
• Ipsilateral pain/temperature loss of face (trigeminal [CNV] nuclei)

Front 17

Other than the diagnostic signs, what are symptoms associated with Wallenberg's Syndrome?

Back 17

• Dysphagia
• Dysarthria
• Dysphonia (vocal quality)
• Vertigo (vertebral symptom)
• Nausea (vertebral symptom)
• Horner's Syndrome due to SNS involvement (Pupil constriction, ptosis, decreased sweating)
• Ipsilateral ataxia (cerebellar symptom)

Front 18

• Which artery supplies the pons, superior cerebellar peduncles, and portions of the midbrain, diencephalon, and cerebellum?
• What are potential injuries that may result from occlusion of this artery? What may this damage result from?

Back 18

• The basilar artery
  
• Tetraplegia, coma, or locked-in syndrome as a result of pontine damage

Front 19

• Which arteries supply the cerebellum? Where do they arise from?
  
• What are possible symptoms of cerebellar stroke?
  

Back 19

• Two branches of the basilar (superior cerebellar & AICA); One branch of vertebral (PICA)
• Direction-changing nystagmus, dizziness, nausea/vomiting, ipsilateral ataxia

Front 20

Putaminal Hemorrhage

Back 20

Similar to MCA Syndrome, greater alterations of consciousness

Front 21

Thalamic Hemorrhage

Back 21

Contraleteral hemi with disproportionately greater sensory loss

Front 22

Cerebellar Hemorrhage

Back 22

Ataxia and vestibulopathy