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Flashcards in effects of strokes Deck (50):
1

areas of stroke are divided to

1. anterior circulation
2. posterior circulation

2

strokes - anterior circulation - arteries

1. middle cerebral artery
2. anterior cerebral artery
3. lenticulo-striate artery

3

stroke on middle cerebral artery - area of lesion

motor cortex - upper limb and face
sensory cortex - upper limb and face
termpal lobe - wernicke area
frontal lobe - broca area

4

stroke on middle cerebral artery - motor cortex - symptoms

contralateral paralyisis of upper limb and face

5

stroke on middle cerebral artery - sensory cortex - symptoms

contralateral loss of sensation upper limb and face

6

stroke on middle cerebral artery - temporal/frontal cortex - symptoms

if in dominant --> aphasia
if non dominant --> hemineglect

7

stroke on anterior cerebral artery - area of lesion

motor cortex - lower limb
sensory cortex - lower limb

8

stroke on anterior cerebral artery - motor cortex - symptoms

contralateral paralyisis of the lower limb

9

stroke on anterior cerebral artery - sensory cortex - symptoms

contralateral loss of senseation of lower limb

10

stroke on lenticulo-striate artery - area of lesion

1. striatum
2. internal capsule

11

stroke on lenticulo-striate artery - symptoms

Contralateral hemiparesis/hemiplegia (face + body)
(absence of cortical signs. eg. neglect, aphasia, visual field loss)

12

a common cause of stroke on lenticulo-striate artery - and why

2ry to unmanaged hypertension because is a common location of lacunar infarcts

13

strokes - posterior circulation - arteries

1. anterior spinal artery
2. posterior inferior cerebellar artery
3. anterior inferior cerebellar artery
4. posterior cerebral artery
5. basilar artery

14

stroke of anterior spinal artery - area of lesion and symptoms

1. lateral corticospinal tract - contralateral hemiparesis (upper and lower limbs)
2. medial lemniscus - decreased contralateral proprioception
3. Caudal medulla/hypoglossal nerve - ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally)

15

stroke of anterior spinal artery is commonly ....

bilateral

16

medial medullary syndrome is caused by

infarct of paramedian branches of anterior spinal artery and vertebral arteries

17

stroke of posterior inferior cerebellar artery - area of lesion

lateral medulla (Lateral medullary (wallenberg) syndrome): 1. vestibular nuclei 2. lateral spinothalamic tract 3. spinal trigeminal nucleus 4. nucleus ambiguus (vagus) (μεικτός), 5. sympathetic fibers
6. inferior cerebellar peduncle

18

stroke of posterior inferior cerebellar artery - symptoms

vomiting, vertigo, nystagmus, decreased pain and Q sensation from ipsilateral face and contralateral body, dysphagia, hoarness, decreased gag reflex, ipsilateral Horner, ataxia, dysmetria

19

Lateral medullary (wallenberg) syndrome (specific involvement)

POSTERIOR INFERIOR CEREBELLAR ARTERY SYNDROME (STROKE)
nucleus ambiguus effects are specific

20

stroke of posterior cerebral artery - area of lesion

occipital cortex
visual cortex

21

stroke of posterior cerebral artery - symptoms

contralateral hemianopia with macular sparing

22

stroke of basilar artery - area of lesion (areas and structures)

1. pons, medulla, lower midbrain,
2. corticospinal and corticobulbar (UMN)
3. ocular cranial nerve nuclei
4. paramedian pontine reticular formation

23

stroke of basilar artery - symptoms

locked-in syndrome :
1. preserved consciousness, blinking + vertical eye movement
2. quadriplegia
3. loss of voluntary facial, mounth and tongue movemetns

24

stroke of anterior inferior cerebellar artery - area of lesion

lateral pons: (LATERAL PONTINE SYNDROME)
- cranial nerve nuclei (vestibular, facal, spinal trigeminal, cochlear,)
- sympthathetic fibers
- middle and inferior cerebellar peduncles
- lateral spinothalamic tract
- corticospinal tract

25

stroke of anterior inferior cerebellar artery - symptoms

LATERAL PONTINE SYNDROME
- vomiting, vertigo, nystagmus
- face paralysis, decreased lacrimation and salivation, decreased taste of the anterior 2/3 of the tongue
- ipsilateral decreased pain and Q of the face and contralateral of the body
- ataxia dysmetria

26

lateral pontine syndrome - specific lesion

facial nucleus

27

lateral medullary (wallenberg) syndrome - artery?

posterior inferior cerebellar

28

posterior communicating artery - lesion

saccular aneurysm
(not strokes)

29

posterior communicating artery aneurysm - symptoms

CNS III palsy --> eye is down and out with ptosis and mydriasis

30

anterior communicating arteries - lesion

most commonly saccular aneurysm (berry) that can impinge cranial nerves. It can lead to stroke

31

anterior communicating arteries - symptoms

- visual field defects (bitemporal hemianopia)
- visual acuity defecits
- Rupture --> ischemia in ACA distribution --> contralateral lower extremity hemiparesis, sensory deficits

32

central post-stroke pain syndrome - definition

Neuropathic pain due to thalamic lesions

33

central post-stroke pain syndrome - course

initial paresthesias followed in weeks to months by allodynia and dysesthesia

34

central post-stroke pain syndrome - occurs in

10% of stroke patient

35

10% of stroke patient can experience ...

central post-stroke pain syndrome -

36

allodynia

ordinarily painless stimuli cause pain

37

dysesthesia

abnormal unpleasant sensation felt when touched

38

paresis vs plegia

paresis --> weakness
plegia --> paralysis

39

common locations of lacunar infarcts

1. basal ganglia
2. internal capsule
3. thalamus
4. pons
(Oxford handbook)

40

stoke - dysphagia and hoarseness - artery?

posterior inferior cerebellar artery

41

stroke - paralysis of face and loss of lacrimation - artery

Anterior inferior cerebellar artery

42

cause of medial medullary syndrome

infarct of paramedian branches of anterior spinal artery and vertebrate arteries

43

cause of lateral medullary (Wallenberg) syndrome

infarct of posterior inferior cerebral artery

44

cause of lateral pontine syndrome

anterior inferior cerebellar artery

45

stroke - contralateral hemianopia with macular sparing - artery

posterior cerebral artery

46

Lateral medullar (Wallenberg) syndrome - specific lesion

Nucleus ambiguus

47

stroke - locked-in syndrome - artery

Basilar artery

48

CN III palsy by sacular aneyrism - artery

posterior communicating artery

49

most common lesion of anterior communicating artery

aneurysm

50

lesions of posterior communicating artery

Lesions are typically aneyrisms (CN III paralysis)
NOT STROKES