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46 Cards in this Set
- Front
- Back
Bilateral amygdala lesion
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Kluver-Bucy syndrome - hyperorality, hypersexuality, disinhibited behavior
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Frontal lobe lesion
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disinhibition and deficits in concentration, orientation, and judgement; may have reemergence of primitive reflexes
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Right parietal lobe lesion
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Spatial neglect syndrome (agnosia of the contralateral side of the world)
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Reticular activating system(midbrain) lesion
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reduced levels of arousal and wakefulness (eg. coma)
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Bilateral mammillary body lesion
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Wernicke-Korsakoff syndrome (Wernicke- confusion, opthalmoplegia, ataxia) (Korsakoff- memory loss, confabulation, personality changes)
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Basal ganglia lesion
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may result in tremor at rest, chorea, athetosis
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Cerebellar hemisphere lesion
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Intention tremor, limb ataxia, damage to the cerebellum results in ipsilateral deficits: fall toward side of lesion
(cerebellum -> SCP -> contralateral ctx -> CST decussation = ipsilateral |
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cerebellar vermis lesion
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truncal ataxia, dysarthria
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subthalamic nucleus lesion
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contralateral hemiballismus
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hippocampal lesion
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anterograde amnesia- inability to make new memories
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paramedian pontine reticular formation (PPRF) lesion
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eyes look AWAY from side of lesion
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frontal eye fields lesion
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eyes look TOWARD lesion
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central pontine myelinolysis
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acute paralysis, dysarthria, dysphagia, diplopia, and LOC
commonly caused by very rapid correction of hyponatremia abnormal increased MRI signal in the pons |
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recurrent laryngeal nerve injury
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loss of all laryngeal muscles except cricothyroid (inn. by superior laryngeal)
hoarseness |
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conduction aphasia
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poor repetition but fluent speech, intact comprehension
arcuate fasciculus lesion (connects Broca's and Wernicke's areas) |
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Broca's aphasia
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nonfluent aphasia with intact comprehension
Broca's area= inferior frontal gyrus |
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Wernicke's aphasia
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Fluent aphasia with impaired comprehension
Wernicke's area = superior temporal gyrus |
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global aphasia
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nonfluent aphasia with impaired comprehension. both broca's and wernicke's areas affected
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anterior spinal artery (medial medullary syndrome)
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contralateral hemiparesis (lower extremities), medial lemniscus (decreased contralateral proprioception), ipsilateral paralysis of hypoglossal nerve
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PICA (lateral medullary syndrome, aka Wallenberg's)
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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 |
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AICA (lateral inferior pontine syndrome)
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ipsilateral facial paralysis, ipsilateral cochlear nucleus, vestibular (nystagmus), ipsilateral facial pain and temperature, ipsilateral dystaxia (MCP, ICP)
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posterior cerebral artery
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contralateral hemianopia with macular sparing
supplies occipital cortex |
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middle cerebral artery
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contralateral face and arm paralysis and sensory loss, aphasia (dominant sphere), left-sided neglect
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anterior cerebral artery
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supplies anteromedial surface of the brain
leg-foot area of motor and sensory cortices |
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anterior communicating artery
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*most common site of circle of Willis aneurysm -> berry aneurysm
lesions may cause visual field defects (Acom runs behind optic chiasm) |
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posterior communicating artery
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common area of aneurysm
causes CN III palsy |
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lateral striate
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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 |
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watershed zones
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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 |
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basilar artery
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infarct causes "locked-in syndrome" (CN 3 is typically intact)
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stroke of anterior circle, in general
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general sensory and motor dysfunction, aphasia
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stroke of posterior circle, in general
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cranial nerve deficits (vertigo, visual deficits), coma, cerebellar deficits (ataxia)
dominant hemisphere (ataxia) nondominant (neglect) |
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berry aneurysms
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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 |
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Charcot-Bouchard microaneurysms
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assoc. w/ chronic HTN
affect small vessels (in basal ganglia, thalamus) |
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epidural hematoma
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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 |
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subdural hematoma
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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 |
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subarachnoid hemorrhage
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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 |
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parenchymal hematoma
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caused by HTN, amyloid angiopathy
lobar strokes all over brain, diabetes, and tumor. typically occurs in basal ganglia and internal capsule |
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Ring-enhancing lesion
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metastasis, abscesses, toxoplasmosis, AIDS lymphoma
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uniformly enhancing lesion
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lymphoma, meningioma, metastases(usually ring-enhancing)
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heterogeneously enhancing lesion
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glioblastoma multiforme
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glioblastoma multiforme
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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 |
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meningioma
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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) |
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schwannoma
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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 |
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oligodendroglioma
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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 |
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pituitary adenoma
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most common prolactinoma. bitemporal hemianopia (due to pressure on optic chiasm) and hyper- or hypopituitarism are sequelae
Rathke's pouch |
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pilocytic (low-grade) astrocytoma
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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) |