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46 Cards in this Set

  • Front
  • Back
Bilateral amygdala lesion
Kluver-Bucy syndrome - hyperorality, hypersexuality, disinhibited behavior
Frontal lobe lesion
disinhibition and deficits in concentration, orientation, and judgement; may have reemergence of primitive reflexes
Right parietal lobe lesion
Spatial neglect syndrome (agnosia of the contralateral side of the world)
Reticular activating system(midbrain) lesion
reduced levels of arousal and wakefulness (eg. coma)
Bilateral mammillary body lesion
Wernicke-Korsakoff syndrome (Wernicke- confusion, opthalmoplegia, ataxia) (Korsakoff- memory loss, confabulation, personality changes)
Basal ganglia lesion
may result in tremor at rest, chorea, athetosis
Cerebellar hemisphere lesion
Intention tremor, limb ataxia, damage to the cerebellum results in ipsilateral deficits: fall toward side of lesion
(cerebellum -> SCP -> contralateral ctx -> CST decussation = ipsilateral
cerebellar vermis lesion
truncal ataxia, dysarthria
subthalamic nucleus lesion
contralateral hemiballismus
hippocampal lesion
anterograde amnesia- inability to make new memories
paramedian pontine reticular formation (PPRF) lesion
eyes look AWAY from side of lesion
frontal eye fields lesion
eyes look TOWARD lesion
central pontine myelinolysis
acute paralysis, dysarthria, dysphagia, diplopia, and LOC

commonly caused by very rapid correction of hyponatremia

abnormal increased MRI signal in the pons
recurrent laryngeal nerve injury
loss of all laryngeal muscles except cricothyroid (inn. by superior laryngeal)

hoarseness
conduction aphasia
poor repetition but fluent speech, intact comprehension

arcuate fasciculus lesion (connects Broca's and Wernicke's areas)
Broca's aphasia
nonfluent aphasia with intact comprehension

Broca's area= inferior frontal gyrus
Wernicke's aphasia
Fluent aphasia with impaired comprehension

Wernicke's area = superior temporal gyrus
global aphasia
nonfluent aphasia with impaired comprehension. both broca's and wernicke's areas affected
anterior spinal artery (medial medullary syndrome)
contralateral hemiparesis (lower extremities), medial lemniscus (decreased contralateral proprioception), ipsilateral paralysis of hypoglossal nerve
PICA (lateral medullary syndrome, aka Wallenberg's)
contralateral loss of pain and temperature, ipsilateral dysphagia, hoarseness, decreased gag reflex, vertigo, diplopia, nystagmus, vomiting

ipsilateral Horner's, ipsilateral facial pain and temperature trigeminal nucleus (spinal tract and nucleus), ipsilateral ataxia
AICA (lateral inferior pontine syndrome)
ipsilateral facial paralysis, ipsilateral cochlear nucleus, vestibular (nystagmus), ipsilateral facial pain and temperature, ipsilateral dystaxia (MCP, ICP)
posterior cerebral artery
contralateral hemianopia with macular sparing

supplies occipital cortex
middle cerebral artery
contralateral face and arm paralysis and sensory loss, aphasia (dominant sphere), left-sided neglect
anterior cerebral artery
supplies anteromedial surface of the brain

leg-foot area of motor and sensory cortices
anterior communicating artery
*most common site of circle of Willis aneurysm -> berry aneurysm

lesions may cause visual field defects (Acom runs behind optic chiasm)
posterior communicating artery
common area of aneurysm
causes CN III palsy
lateral striate
divisions of middle cerebral artery; supply internal capsule, caudate, putamen, globus pallidus

"arteries of stroke"
infarct of the posterior limb of the internal capsule causes pure motor hemiparesis
watershed zones
between anterior cerebral/middle cerebral, posterior cerebral/middle cerebral arteries

damaged in severe hypotension --> upper leg/upper arm weakness, defects in higher-order visual processing
basilar artery
infarct causes "locked-in syndrome" (CN 3 is typically intact)
stroke of anterior circle, in general
general sensory and motor dysfunction, aphasia
stroke of posterior circle, in general
cranial nerve deficits (vertigo, visual deficits), coma, cerebellar deficits (ataxia)

dominant hemisphere (ataxia)
nondominant (neglect)
berry aneurysms
occur at the bifurcations in the circle of Willis- most common site is the anterior communicating artery

most common complication - rupture! leading to hemorrhagic stroke/subarachnoid hemorrhage

assoc. w/ adult polycystic kidney disease, Ehlers-Danlos syndrome, and Marfan's syndrome

risk factors: advanced age, HTN, smoking, black race

histo: no internal elastic lamina at origin of aneurysm
Charcot-Bouchard microaneurysms
assoc. w/ chronic HTN
affect small vessels (in basal ganglia, thalamus)
epidural hematoma
rupture of middle meningeal artery (branch of maxillary artery), often secondary to fracture of temporal bone

lucid interval
rapid expansion under systemic arterial pressure -> transtentorial herniation, CN III palsy

CT shows "biconvex disk" NOT crossing suture lines. CAN cross falx, tentorium
subdural hematoma
rupture of bridging veins. slow venous bleeding (less pressure- hematoma develops over time) with delayed onset of symptoms

seen in elderly, alcoholics, blunt trauma, shaken baby (predisposing factors- brain atrophy, shaking, whiplash)

crescent-shaped hemorrhage that crosses suture lines. gyri are preserved, since pressure is distributed equally. canNOT cross falx, tentorium
subarachnoid hemorrhage
rupture of an aneurysm (usually berry aneurysm in Marfan's, Ehler-Danlos, APCKD) or an AVM. Patients complain of "worst headache of my life."

Bloody or yellow (xanthochromic) spinal tap. 2-3 days afterward, there is a risk of vasospasm due to blood breakdown producs, which irritate vessels (treat with calcium channel blockers)-nimodipine
parenchymal hematoma
caused by HTN, amyloid angiopathy

lobar strokes all over brain, diabetes, and tumor. typically occurs in basal ganglia and internal capsule
Ring-enhancing lesion
metastasis, abscesses, toxoplasmosis, AIDS lymphoma
uniformly enhancing lesion
lymphoma, meningioma, metastases(usually ring-enhancing)
heterogeneously enhancing lesion
glioblastoma multiforme
glioblastoma multiforme
most common primary brain tumor
found in cerebral hemispheres, can cross corpus callosum ("butterfly glioma". Stain astrocytes for GFAP

prognosis grave; <1-year life expectancy

see "pseudopalisading" pleomorphic tumor cells- border central areas of necrosis and hemorrhage
meningioma
second most common primary brain tumor. most often occurs in convexities of hemispheres and parasagittal region. arises from arachnoid cells external to brain. Resectable

see spindle cells concentrically arranged in whorled pattern; psammoma bodies (laminated calcifications)
schwannoma
3rd most common brain tumor. Schwann cell origin - often localized to CN VIII --> acoustic schwannoma

Usually found at cerebellopontine angle. Resectable. S-100 positive.

*Bilateral schwannomas found in neurofibromatosis type 2
oligodendroglioma
relatively rare, slow growing. most often in frontal lobes. chicken-wire capillary pattern

oligodendrocytes = "fried egg" cells- round nuclei with clear cytoplasm. often calcified in oligodendroglioma
pituitary adenoma
most common prolactinoma. bitemporal hemianopia (due to pressure on optic chiasm) and hyper- or hypopituitarism are sequelae

Rathke's pouch
pilocytic (low-grade) astrocytoma
usually well-circumscribed. in children, most often found in posterior fossa. may be supratentorial.

GFAP positive. benign; good prognosis

See Rosenthal fibers- eosinophilic, corkscrew fibers. Cystic and solid (gross)