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Buzz Words Flashcards

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1
Q

ipsilateral CN III palsy and contralateral hemiplegia

A

Weber’s syndrome (midbrain lesion)

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2
Q

limited upgaze, convergence retraction nystagmus, light-near dissociation, lid retraction, skew deviation of eyes

A

Parinaud’s syndrome (lesion affecting quadrigeminal plate, dorsal midbrain)

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3
Q

Gerstmann’s syndrome (4 signs, lesion location)

A
  1. finger agnosia
  2. right-left disorientation
  3. agraphia
  4. acalculia

lesion of dominant inferior parietal lobe near angular gyrus

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4
Q

vascular supply to bilateral medial thalami

A

artery of Percheron (normal variant, arising from P1)

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5
Q

“man in a barrel” syndrome - proximal weakness

A

watershed infarcts

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6
Q

cerebral amyloid angiopathy

A

lobar hemorrhages
microhemorrhages on MRI gradient echo
congo-red positive - apple-green birefringence

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7
Q

moya moya disease

A

bilateral stenosis of distal ICAs and intracranial arteries of circle of willis. –> extensive collaterals –> “puff of smoke”

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8
Q

vascular supply of thalamus (4 arteries)

A
  1. tuberothalamic (from Pcomm) - supplies anterior thalamus - ventral anterior nucleus
  2. paramedian (from P1) - medial thalamus - dorsomedial nucleus
  3. thalmogeniculate (from P2) - lateral - ventral lateral nuclei
  4. posterior choroidal (from P2) - posterior - pulvinar
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9
Q

anterior limb of internal capsule - vascular supply

A

recurrent artery of Heubner (ACA)

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10
Q

superior division MCA stroke

A

hemiparesis of arm and face
gaze deviation (frontal eye fields)
Broca’s aphasia (dominant inferior frontal gyrus)

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11
Q

inferior division MCA stroke

A

Wernicke’s aphasia

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12
Q

lenticulostriate artery infarct

A

pure motor - affects posterior limb of IC

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13
Q

clumsy hand-dysarthria syndrome

A

lacunar stroke of paramedian pons contralateral to the clumsy hand

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14
Q

what does anterior choroidal artery supply (name 4)

A

it’s a branch of ICA that suppliesPOSTERIORLIMBOFINTERNALCAPSULE, choroid plexus, Gpi and geniculocalcarine tract

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15
Q

hyperdense MCA sign

A

atheroembolic occlusion of MCA. poor prognosis

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16
Q

ABCD2 score

A

predict stroke risk after TIA
Age > 60
Bp > 140/90
Clinical sx
Duration sx
Diabetes

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17
Q

lateral medullary syndrome

A

PICA stroke
vertigo, nystagmus, N/V, ipsi face pain&Tloss,contra-body-pain&Tloss

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18
Q

tPA exclusion criteria for 3-4.5 hours

A

NIHSS > 25
age > 80
hx stroke and DM
any anticoag use

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19
Q

AICA stroke vs PICA stroke sx

A

AICA –> unilateral hearing loss
labyrinthine artery is a branch of AICA
ventral cerebellum

PICA –> dysphagia
dorsal cerebellum

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20
Q

CN III palsy + contralateral tremor/chorea

A

ventral mesencephalic tegmentum stroke

localizes to side of CN III palsy

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21
Q

alexia without agraphia

A

L occipital infarct involving splenium

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22
Q

complete periph facial palsy with contralateral hemiplegia of arm/leg

A

Millard Gubler syndrome

stroke to ventrocaudal pons
affects corticospinal tract (sparing face), CN 6 and 7 fascicles –> diplopia, can’t abduct ipsi eye, ipsi peripheral facial palsy

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23
Q

ipsilateral peripheral CN 7 palsy, gaze paresis, contralateral hemiparesis

A

Foville syndrome-medial-pontine

hits ipsi PPRF –> horiz gaze palsy
ipsi CN 7 –> LMN face palsy
internuclear ophthalmoplegia
contralateral body weakness

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24
Q

tongue weakness + contralateral arm/leg weakness, contralateral loss of touch/vibr/proprio

Study These Flashcards
A

medial medullary syndrome (Dejerine syndrome)

  • vert or medial branch of vert is occluded (ant spinal artery)
  • stroke to pyramid (weakness), medial lemniscus (vibr/proprio), hypoglossal fibers (tongue)
25
who needs oral AC to prevent stroke?
cardioembolic source- - intracardiac thrombus - anterior wall akinesis and dec EF - a fib - mechanical valves
26
where does anterior choroidal artery branch off from
internal carotid artery
27
where does posterior choroidal artery branch off of
PCA
28
risk factors for CVST
prothombotic state: birth control, cancer, pregnancy, antiphospholipid syndrome, heme disorders, trauma, protein C/S deficiency, prothrombin mutation, Factor V Leiden, antithrombin deficiency, homocysteinemia infection: middle ear infection, mastoiditis
29
migraines, strokes at young age, dementia
CADASIL Notch 3 mutation Dx by genetics or skin biopsy blood vessels with thick walls (arteriopathy)
30
what factors do you consider to determine if someone with A fib needs anticoagulation
CHADSVASc CHF HTN Age > 75 DM Stroke/TIA Vascular dz Sex (females higher risk)
31
inferior anastomatic vein
vein of Labbe
32
TIA + intracranial stenosis. tx?
Aspirin 325 only. May also do Plavix for 90 days NO anticoagulation NO stenting/EC-IC bypass - worse outcomes
33
lobar hemorrhages, Alzheimer's
amyloid angiopathy
34
where does the Left common carotid arise from?
left common carotid is a branch of the aortic arch directly occasionally will arise from same origin as innominate artery, or from the innominate artery itself
35
where does each vertebral artery arise from?
left vertebral artery arises from left subclavian artery (which comes off the aortic arch) the right vert comes off the right subclavian which arises from the innominate (brachiocephalic) artery
36
where does the common carotid bifurcate (what level)
C4
37
spinal dural AVF
presents more commonly in men and over 50 progressive myelopathy - pain, weakness, sensory symptoms, gait disturbance usually lower thoracic/lumbar spinal angiogram is gold standard to find the feeding artery tx: endovascular embolization/surgical disconnection T2 hyperintense over several levels and perimedullary flow voids
38
aging blood on MRI: isointense on T1, hyperintense on T2
hyperacute (<12 hours) mostly oxyhemoglobin
39
aging blood on MRI - isointense on T1, hypointense on T2
acute (12 hours to 2 days) deoxyhemoglobin
40
aging blood on MRI - hyperintense on T1, hypointense on T2
early subacute (2-7 days) intracellular methemoglobin
41
aging blood on MRI - hyperintense on both T1 and T2
late subacute (8 days to 1 month) extracellular methemoglobin
42
aging blood on MRI - iso/hypointense on T1, hypointense on T2
chronic (>1 month, years) hemosiderin
43
most common cause of nontraumatic SAH
aneurysm rupture
44
most common aneurysm places
A comm > P comm > MCA bifurcation > ICA bifurcation > basilar apex > pericallosal artery > PICA origin
45
dural AVF - what vessels involved, and what affects risk of hemorrhage?
meningeal/dural artery supply draining towards dural venous sinus cortical venous drainage = aggressive, risk of neuro sx and hemorrhage sx: pulsatile tinnitus, headache, seizure, deficits
46
"beading" on angiogram
vasculitis also atherosclerosis, vasospasm, infectious or radiation vasculopathy
47
primary CNS vasculitis treatment
steroids +/- cyclophosphamide
48
thunderclap headache
RCVS - associated with PRES, preeclampsia , amphetamines, cocaine, triptans , more common in women angiogram shows "beading" - should resolve in 12 weeks - follow up with TCD tx: symptomatic, supportive, calcium channel blockers and magnesium. avoid steroids
49
Sensorineural hearing loss after subarachnoid hemorrhage
Superficial siderosis- deposition of hemosiderin in brainstem from chronic slow bleeding
50
Worst HA of life
SAH get CT—> if no blood get LP if no blood think RCVS
51
Mets most likely to bleed
Melanoma and renal cell carcinoma
52
Bilateral temporal lobe hemorrhage
HSV
53
Is it snot or CSF?
Beta 2 transferrin assay
54
Raccoon eyes
Orbital plate fx
55
Battle sign (bruise behind ear)
Fx of petrous part of temporal bone
56
Time window for thrombectomy
24 hours
57
Tpa window
4.5 hours Unless - older than 80 - oral AC use - NIHSS > 25 - hx of DM AND stroke Then you only have 3 hours
58
Branch retinal artery occlusion, sensorineural hearing loss, encephalopathy. Mri looks like MS
Susac syndrome

Vascular Neuro (1 decks)

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