Neuro Lesions Flashcards by Alex Miller

In normal pressure hydrocephalus, expansion of ventricles distorts the _____

fibers of the corona radiata

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Stroke of the ___ artery causes:
Contralateral paralysis and sensory loss–face and upper limb.
Aphasia if in dominant hemisphere. Hemineglect if in nondominant hemisphere.

Middle Cerebral Artery

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Sx:
headache, tinnitus, diplopia, no change in mental status, papilledema
Enlarged blind spot and peripheral constriction

Idiopathic Intracranial Hypertension

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Stroke of the ___ artery at the _____ causes:

Decreased pain and temperature sensation from contralateral body, ipsilateral face

Posterior Inferior Cerebellar A.
Lateral spinothalamic tract, spinal trigeminal nucleus
(Lateral Medulla)

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Tx for restless leg syndrome?

Pramipexole, ropinirole

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Stroke of the ____ artery causes:
Contralateral hemianopia with macular sparing;
alexia without agraphia (dominant hemisphere)

Posterior cerebral

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Parinaud syndrome is caused by a lesion of the ______

dorsal midbrain

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Athetosis (slow, snake-like, writhing movements; especially seen in fingers) is caused by a lesion of the ____

Basal Ganglia

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Chorea (sudden, jerky, purposeless movements) is caused by a lesion of the ____

Basal Ganglia

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May result in tremor at rest, chorea, athetosis

Lesion of Basal Ganglia (Parkinson disease, Huntington disease)

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Visual hallucinations, dementia with fluctuating cognition/alertness, REM sleep behavior disorder, and parkinsonism

Lewy Body dementia

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Agnosia of the contralateral side of the world

Lesion of Nondominant parietal cortex

aka Hemispatial Neglect Syndrome

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Stroke of the ___ artery at the _____ causes:

Anterior Inferior Cerebellar A.

Spinothalamic tract, spinal trigeminal nucleus (Lateral pons)

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impaired adduction of ipsilateral eye; nystagmus of contralateral eye with abduction

internuclear opthalmoplegia

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Confusion, ataxia, Nystagmus, Opthalmoplegia, memory loss (anterograde and retrograde amnesia), confabulation, personality changes

Wernicke-Korsakoff syndrome

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Stroke of the ___ artery at the _____ causes:

Ipsilateral ataxia, dysmetria

Posterior Inferior Cerebellar A.

Inferior cerebellar peduncle (Lateral Medulla)

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Kluver-Bucy syndrome is caused by a lesion of the ____

bilateral amygdalas

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step-wise decline in cognitive ability with late-onset memory impairment.

vascular dementia

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Triad of urinary incontinence, gait apraxia (magnetic gait), and cognitive dysfunction

Normal pressure hydrocephalus

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Eyes look toward side of hemiplegia

Lesion of the Paramedian Pontine Reticular formation

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Stroke of the ___ artery at the _____ causes:

Dysphagia, hoarseness, decreased gag reflex, hiccups

Posterior Inferior Cerebellar A.
Nucleus Ambiguus (CN IX, X, XI) (Lateral Medulla)
(specific to PICA)

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inability to look toward the side of lesion

ipsilateral gaze palsy

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Hypertensive hemorrhages (Charcot-Bouchard microaneurysms) most often occur in ______, followed by thalamus, pons, and cerebellum.

putamen of basal ganglia (lenticulostriate vessels)

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Locked-in syndrome is caused by disruption of the ___ artery

Basilar

pons, medulla, lower midbrain

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A stroke of the ____ artery causes contralateral paralysis. Absence of cortical signs (eg neglect, aphasia, visual field loss)

lenticulostriate

Presents in a premature/low-birth-weight infant as altered level of consciousness, bulging fontanelle, hypotension, seizures, coma. Bleeding into ventricles.

Neonatal intraventricular hemorrhage

Called Lewy body dementia if cognitive and motor sx onset is less than ____ apart, otherwise considered dementia secondary to Parkinson disease

< 1 year

Reduced levels of arousal and wakefulness (eg, coma) is caused by a lesion of the ____ in the ____

Reticular activating system | midbrain

Neonatal intraventricular hemorrhage originates in the germinal matrix and is due to _______ and _______ in premature infants.

reduced glial fiber support | impaired autoregulation of BP

___ herniation can compress the anterior cerebral artery

Cingulate (subfalcine) | - under the falx cerebri

Uncus = median ___ lobe

temporal

Stroke of the ___ artery at the _____ causes: | Ipsilateral Horner syndrome

``` Posterior Inferior Cerebellar A. sympathetic fibers (Lateral Medulla) ```

Stroke of the ___ artery at the _____ causes: | Vomiting, vertigo, nystagmus

``` Posterior Inferior Cerebellar A. Vestibular nuclei (Lateral Medulla) ```

____ posturing is caused by a lesion AT OR BELOW the red nucleus (of the midbrain)

Decerebrate (extensor) | - extension of upper and lower extremities

Disinhibition and deficits in concentration, orientation, judgment; may have reemergence of primitive reflexes.

Frontal Lobe lesion

Symptoms of ACom compression?

bitemporal hemianopsia (compression of optic chiasm); visual acuity deficits

Symptoms of PCom compression?

ipsilateral CN III palsy --> mydriasis ("blown pupil"), may also have ptosis, "down and out" eye

___ herniation can compress CN III, Posterior Cerebral A., and the paramedian A (Duret hemorrhages), leading to an ipsilateral blown pupil with contralateral hemiparesis

uncal transtentorial

contralateral hemiballismus

lesion of subthalamic nucleus

Stroke of the ___ artery at the _____ causes: | Paralysis of face (LMN), decreased lacrimation, decreased salivation, decreased taste from anterior 2/3 of tongue

``` Anterior Inferior Cerebellar A. Facial nucleus (Lateral Medulla) ```

Which type of posturing has a worse prognosis?

Decerebrate posturing

Lateral Pontine syndrome is caused by disruption of the ___ artery

AICA

lesion causes Intention tremor, limb ataxia, loss of balance

cerebellar hemisphere lesion (ipsilateral deficits; fall towards side of lesion)

Hemiballismus is caused by a lesion of the ____

Contralateral subthalamic nucleus (lacunar stroke)

Stroke of the ___ artery causes: Quadriplegia and loss of horizontal (but not vertical eye movements) RAS is spared = preserved consciousness

Basilar

Stroke of the ___ artery causes: | Contralateral paralysis. Absence of cortical signs (eg, neglect, aphasia, visual field loss)

Lenticulostriate

Lesion of ___ causes internuclear opthalmoplegia

Medial Longitudinal fasciculus

Stroke of the ___ artery at the _____ causes:

``` Anterior Inferior Cerebellar A. Sympathetic fibers (Lateral pons) ```

Guillain barre syndrome is also known as what?

Acute inflammatory demyelinating polyradiculopathy

Stroke of the ___ artery at the _____ causes:

Anterior Inferior Cerebellar A. | Middle and Inferior Cerebellar Peduncles (Lateral pons)

____ posturing is caused by a lesion ABOVE the red nucleus (of the midbrain)

Decorticate (flexor) | - flexion of upper extremities, extension of lower extremities

Agraphia, acalculia, finger agnosia, left-right disorientation

Lesion of Dominant parietal cortex | aka Gertmann syndrome

Symptoms of MCA rupture?

contralateral upper extremity and lower facial hemiparesis, sensory deficits

Intention tremor is caused by a lesion of the ____; | Resting tremor is caused by a lesion of the ____.

Cerebellar dysfunction; | Substantia nigra

disinhibited behavior (eg, hyperphagia, hypersexuality, hyperorality)

Kluver-Bucy syndrome

Medial Medullary syndrome is caused by an infarct of the ______ and/or _____

paramedian branches of ASA | vertebral arteries

___ herniation can lead to coma and death due to brainstem compression

Cerebellar tonsillar | - into the foramen magnum

___ herniation can cause caudal displacement of the brain stem, leading to rupture of paramedian basilar artery branches --> Duret hemorrhages (usually fatal)

Central/ downward transtentorial

Lesion of the ___ causes truncal ataxia (wide-based, "drunken sailor" gait), nystagmus

cerebellar vermis | - associated with chronic alcohol abuse

Destructive lesion such as an MCA stroke: eyes look towards the side of the lesion (or at the hemiplegia). Irritative lesion such as seizures: eyes look at the shaking arm and leg.

Frontal eye field lesion

Anterograde amnesia -- inability to make new memories

Hippocampus (bilateral lesions)

Wernicke-Korsakoff syndrome is caused by a lesion of the ______

bilateral Mammillary bodie

Stroke of the ___ artery causes: Contralateral paralysis--upper and lower limbs. Decreased proprioception Ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally)

Anterior Spinal Artery (aka Medial Medullary Syndrome)

Symptoms of ACom rupture?

contralateral lower extremity hemiparesis, sensory dificits

vertical gaze palsy, pupillary light-near dissociation, lid retraction, convergence-retraction nystagmus

Parinaud syndrome

Lateral medullary (Wallenberg) syndrome is caused by disruption of the ___ artery

PICA

Stroke of the ___ artery causes: | Contralateral paralysis and sensory loss--lower limb, urinary incontinence.

Anterior Cerebral Artery

Neuro Lesions Flashcards

(67 cards)