Vascular Lesions

Front 1

What can cause a stroke?

Back 1

atherosclerosis
thrombus
emboli

Front 2

How does an intracerebral hemorrhage cause a stroke?

Back 2

rupture of vessel wall due to hypertension

Front 3

What are the two systems that feed blood to the brain?

Back 3

internal carotid
verteberobasilar

Front 4

Compare and contrast the internal carotid and verteberobasilar system for motor deficits?

Back 4

intl carotid-contralateral
verteberobasilar-bilateral

Front 5

Compare/contrast intl carotid and verteberobasilar system for sensory deficit?

Back 5

intl carotid-contralateral
verteberobasilar-bilateral

Front 6

Compare/contrast visual deficit for intl carotid and verteberobasilar system?

Back 6

intl cartoid-monocular blindness in contralateral field
verterberobasilar - bilateral, cortical blindness

Front 7

Comapre/contrast intl carotid and vertberobasilar system for speech deficit/aphasia?

Back 7

intl carotid - present
verteberobasilar - absent

Front 8

Compre/contrast cranial nerve deficit in intl carotid and verteberobasilar?

Back 8

intl carotid - absent
verteberobasilar - present

Front 9

Symptoms of unilateral anterior cerebral artery syndrome?

Back 9

1)contralateral hemiplegia/paresis focused on lower extremity
2) contralateral sensory deficit esp lower extremity
3) transportical motor aphasia where left dominant hemisphere is affected

Front 10

Symptoms of bilateral anterior cerebral artery syndrome?

Back 10

1)abullia
2) apathy
3) memory change
4) emotional Δ
5) akinetic mutism
6) gait and posture Δ
7) grasp reflex
8) spinchter control Δ

Front 11

what is abullia?

Back 11

loss of initiative and spontaneity

Front 12

What is akinetic mutism?

Back 12

complete unresponsivness with eyes open only

Front 13

Why do you get bilateral anterior cerebral artery syndrome vs unilateral anterior cerebral artery syndrome?

Back 13

bilateral - anterior cerebral arteries arise from a single trunk
unilateral - anterior cerebral arteries arise from diff trunks

Front 14

What is the medial straite artery a branch of?

Back 14

anterior cerebral artery

Front 15

Symptoms of recurrent artery of heubner?

Back 15

1)contralateral face and arm weakness
2) no sensory loss in face and arm
3) behavioral Δ - aphasia, abulia, agitation

Front 16

Where does anterior choroidal artery branch off?

Back 16

internal carotid

Front 17

Can you have anterior choroidal artery occulsion and be asymptomatic?

Back 17

yes

Front 18

Symptoms of unilateralanterior choridal artery syndrome?

Back 18

1) hemiplegia contralateral motor deficit esp upper body face
2) contralateral hemisensory deficit
3) contralateral visual field defect

Front 19

What happens if you lesion the middle cerebral artery in the initial trunk? (distribution)

Back 19

a large cortical area is affected

Front 20

Symptoms of lesion of middle cerebral artery in initial trunk?

Back 20

1)contralateral gaze problems
2) hemiplegia
3) hemisensory loss/spatial neglect
4) hemianopsia
5) global aphasia (if on left/dominant side)
6)coma from edema

Front 21

What is the distribution of an injury to the middle cerebral artery at the lenticular straite area?

Back 21

straitum injury with cortical sparing

Front 22

What are the symptoms of middle cerebral artery? (4)

Back 22

1)contralateral hemiplegia
2) hemisensory loss
3) transcortical motor
4) transcortical sensory aphasia if one the left side (dominant side)

Front 23

What are symptoms if you have a discrete lesion of middle cerebral artery?

Back 23

1)contralateral weakness and sensory loss of face and hang
2) condcution aphasia if on left/dominant side
3) constructional dyspraxia (if on non dominant/right side)

Front 24

What is the most frequently encountered stroke syndrome?

Back 24

middle cerebral artery syndrome

Front 25

General symptoms of middle cerebral artery syndrome? (4)

Back 25

1)contralateral hemiplegia/paresis
esp in contralateral hand, face and upper extremity
2) contralateral sensory deficit esp in face and upper extremity with pain and temp affected less
3) contralateral visual field dificit
4) contralateral conjugate gaze paralysis
5) aphasia if dominant hemisphere involved
6)inattention and neglect on contralateral side of body if non dominant hemisphere involved
7) spatial perception disorders if non dominant hemisphere is involved
8) Gerstman syndrome

Front 26

How does middle cerebral artery syndrome change if you are having issues with the dominant side or non dominant side?

Back 26

Dominant side/left - aphasia
Non dominant side - neglect of contralateral side, spatial perception disorder

Front 27

What is a cortical infarct caused by?

Back 27

MCA infart involving ventral head regoins of prefrontal gyrus which affects precentral gyrus and Brocas area

Front 28

What artery does lenticulostraite arteries branch off?

Back 28

middle cerebral

Front 29

What do lenticulostraites supply?

Back 29

internal capsule

Front 30

What is capsular hemiplegia associated with?

Back 30

Corticobulbars and corticospinals of internal capsule are affeceted with middle cerebral artery is compromised

Front 31

What are the symptoms of lenticulostraite artery syndrome?

Back 31

pure motor hemiplegia

Front 32

What are the symptoms of unique posterior cerebral artery syndrome?

Back 32

1)contralateral visual field deficit (hemianopsia)
2) visual and color agnosia
3) contralateral loss of modalities and pain
4) alexia without agraphia

Front 33

Is the posterior cerebral artery syndrome associated with a motor defifict?

Back 33

no

Front 34

What does the posterior cerebral artery supply?

Back 34

midbrain

Front 35

What syndrome is associated with the branches of the PCA?

Back 35

Webers syndrome

Front 36

What are the symptoms of Weber's syndrome? (5)

Back 36

1)ipsilateral external strabismus (extropia)
2)ptosis
3)mydriasis (pupillary dilation)
4) contralateral spastic hemiplegia
5) positive babinski

Front 37

What condition is associated with vascular lesion in basilar pons?

Back 37

alternating abducent hemiplegia

Front 38

Symptoms of alternating abducent hemiplegia?

Back 38

1)ipsilateral internal strabismus
2) contralateral spastic hemiplegia

Front 39

What conditions is associated with PICA? (2)

Back 39

Wallenberg's syndromem with slight Horner syndrome

Front 40

What are symptoms of Wallenberg's syndrome?

Back 40

Pain and temp -face
larynx and pharynx problem

Front 41

What is disturbed in Wallenberg's syndrome?

Back 41

PICA disrupts
1)spinal tract of V
2) nucleus of V
3) spinothalamics
4) nucleus ambiguus

Front 42

Condition associated with stroke of anterior spinal artery?

Back 42

Alternating hypoglossal hemiplegia

Front 43

What are symptoms of Alternating hypoglossal hemiplegia? (3)

Back 43

1)Ipsilateral tongue deviates to side of lesion
2)Contralateral hemiplegia
3)Contralateral loss of conscious proprioception and vibratory sense

Front 44

What happens in Vertebral-Basilar Arteries syndrome?

Back 44

brain stem infarcts

Front 45

What are the symptoms of the vertebral-basilar arteries syndrome?

Back 45

1)bilateral long tract motor and sensory signs
2) crossed motor and sensory signs
3)cerebellar Δ
4) cranial nerve Δ
5) consciousness Δ
6) disconjugate eye movements

Front 46

What is the mneumonic to remember brainstem stroke?

Back 46

four Ds with crossed findings

Front 47

What is the mneumonic for "four Ds with crossed findings" stand for?

Back 47

1)diplopia
2)dysarthria
3)dysphagia
4)dizziness
crossed findings