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36 Cards in this Set

  • Front
  • Back
what does the MCA supply?
- lateral surface of brain & basal ganglia & internal capsule
what does the ACA supply?
- medial surface of brain & narrow strip around parasagittal lateral surface
what does PCA supply?
- distributed to medial surface of occipital lobe - including primary visual cortex & visual association cortex

- also supplies thalamus
what does variations in the circle of willis do to infarcts?
- end up different because of their different circle of willis & collateral blood flow
how can the external help communicate with internal carotid if it is occluded?
- back flow from the opthalmic connecting to the external going into the internal carotid
much of the sensory & motor cortex is supplied by who?
how does ACA infarct present?
- Leg > arm
how does MCA infarct present?
- arm > leg
what do the lenticulostriate arteries do? where do they come from? what kinds of strokes are they associated with?
- supply the internal capsule & are involved with HTN & lacunes

- small vessel disease, come off of the MCA
lenticulostriate: what does lenticulate supply? striate?
- lenticulate supplies lenticular nucleus which has the putamen & globus palldus

- striatal supplies striatum (with putamen & caudate)

- also supply the posterior internal capsule
how does the MCA run (along what fissure)? what does it do in this fissure?
- along the sylvian fissure

- bifurcates into superior & inferior division
what does a lenticulostriate infarct present like?
- arms = legs (b/c supplies posterior internal capsule where CST fibers run)

- language spared
what happens if the MCA infarct is on the left? on right?
- arm > leg

- language difficulty on left

- dysprosody on right (difficulty putting out emotional content of language)
what is dysprosody on right?
- happens with right MCA infarct

- difficulty putting emotion into language
what artery interferes with language?

- NOT ACA or lenticulostriate
what do the superior & inferior portions of the MCA supply?
- superior: motor & sensory strip, Broca's area, frontal eye fields, superior parietal lobes

- inferior: wernicke's area, much of temporal lobe, inferior parietal lobule
what happens with superior vs inferior MCA infarct?
- superior: motor cortex, hemiparesis (arms/face > legs), brocas aphasia (on left) & confabulation (on right)

- inferior: no hemiparesis, wernicke's aphasia (on left) & spatial problems (on right), visual deficit ("pie in sky" = contralateral superior quadrantanopia)
what happens with PCA infarct?
- contralateral hemianopia (can have alexia without agraphia if interrupt fibers crossing in corpus callosum)

- if occlusion before branches to thalamus then there will be contralateral hemisensory deficit
when do you get alexia without agraphia?
- left PCA infarct that disrupts posterior corpus callosum
what is Anton's syndrome?
- bilateral PCA infarcts (maybe emboli @ top of basilar artery)

- cortical blindness, sometimes with denial of deficit
where do watershed infarcts occur?
- at areas of overlap between vascular territories

- can get these if have quick drop in BP with preexisting atherosclerosis
what in "man in barrel" syndrome?
- watershed infarct b/w ACA & MCA

- sensorimotor strip in proximal arm & proximal leg
where do hemorrhages most likely occur?
- 50% occur in basal ganglia (putamen)

- everything else is 10%

- these are complications of HBP, small vessel disease, same kinds that gave rise
which type of hemorrhage do you get TIA with?
- thrombosis = TIA
how does hemorrhagic stroke develop? what comes along with it?
- gradual development, headache & vomiting
what kind of stroke do you commonly get coma with?
- hemorrhagic
which kind of stroke is an early CT good? early MRI?
- early CT good for hemorrhagic

- early MRI good for thrombosis & embolism, usually neg for hemorrhagic
where do fusiform aneurysms exist? saccular or "berry"?
- fusiform are the rest of the body (atherosclerosis, large arteries)

- saccular are in the brain & at vascular bifurcations
why do aneurysms commonly occur in intracerebral arteries?
- have no external lamina
where are cerebral aneurysms most common?
- anterior circulation = 85%

- posterior circulation = 15% (at top of basilar)
ruptured cerebral hemorrhages are associated with what type of hemorrhage?
- widespread subarachnoid hemorrhage
how do you treat cerebral aneurysms?
- clipping

- coiling - put clips and hope radiologists can put coils in there to thrombose the aneurysm
what is an AV malformation?
- direct connection b/w arterial & venous circulation without capillary bed

- veins under arterial pressure

- hemorrhage from venous side (intraparenchymal or subarachnoid)
how do you treat AVM?
- usually resect part of brain, embolization, radiation
what types of glutamate receptors are thought to be involved in neurotoxicity in hypoxia or ischemia?
- ionotropic glutamate receptors (AMPA, kainite, NMDA)

- NMDA is what is permeable to Ca ions
what happens if you block the glycine site on NMDA receptor?
- prevents channel from opening in response to glutamate