Wiring Demo Flashcards
A 65 y/o LH man with a Hx of HTN and DM had acute onset of left-sided weakness of his arm, leg and face 4 days ago. An initial CT scan was normal.
• He has severe left hemiparesis, increased reflexes at the in the arm and leg. He has a facial droop on the left. He has a left Babinski.
Right frontal cortex.
Babinski sign - UMN –> contralateral
67 y/o RH man presents with acute (3hr) onset of right arm weakness and right facial droop. He is having difficulty formulating his words. There is a right Babinski sign.
Where is the lesion?
Left frontal lobe
NOT SC - because symptoms include face
Babinski sign - upper motor neuron lesion b/c it’s right sied weakness; lesion is on the left
Frontal cortex vs. capsule - he has language problems also. Frontal lobe has the Broca’s area which is for speech.
Why isn’t leg affected - leg along longitudinal fissure along motor cortex which may be fed by another artery in case of stroke
What are lacunar infarcts?
syndrome of “pure motor hemiparesis”
may interrupt the corticospinal tract - internal capsule & pons
A 27 y/o man has multiple trauma from a motor vehicle accident. He cannot move his right arm or leg. CN are normal. On further examination, patient is noted to loss of temperature sensation on left leg but not on his right. How is this explained?
CST?????
No clue! right sided????
