Stroke

Question 1

What symptoms can you get from an MCA infarct (3)

Answer 1

1. Contralateral sensory loss of the UL, LL and lower 2/3rds of the face (primary somatosensory cortex)
2. Contralateral paralysis of the UL, LL, and lower 2/3rds of the face (motor cortex)
3. Ipsilateral eye deviation or homonymous hemianopia (frontal cortex)

Question 2

What symptoms would you expect of a LEFT MCA Infarct?

Answer 2

• Broca aphasia/expressive dysphasia (superior division of MCA)
• Wernicke’s aphasia/receptive dysphasia (inferior division of MCA)

Question 3

Where does a Lacunar Stroke occur? (3)

Answer 3

• Subcortical white matter (internal capsule, corona radiata)
• Basal Ganglia
• Pons
  Originating from small vessels of the MCA (most commonly from the circle of willis)

Question 4

What symptoms would occur in a Lacunar Stroke? (5)

Answer 4

• Pure motor hemiparesis
• Pure sensory loss
• Ataxia +/- hemiparesis
• Sensorimotor stroke
• Dysarthria

Question 5

What are cortical signs? (5)

Answer 5

• Agnosia
• Aphasia
• Neglect
• Apraxia
• Hemianopia

Question 6

What are the functions of the prefrontal cortex? (4)

Answer 6

“EXECUTIVE FUNCTIONS”

• Personality
• Decision making
• Planning/organising
• Complex behaviour

Question 7

What symptoms would you expect to see for an ACA Stroke (rare)? (4)

Answer 7

• Executive dysfunctions (personality and planning movements)
• Sensorimotor function affected to the contralateral LL
• Urinary incontinence
• Speech abnormalities

Question 8

What are generalised symptoms associated with stroke?

Answer 8

• Headache
• Dizziness
• Confusion

Question 9

What symptoms would you expect to see in a PCA stroke?

Answer 9

• Contralateral Homonymous Hemianopia
• Contralateral sensory disturbance (if thalamus affected)
• Motor symptoms are less common

Question 10

What structures make up the brainstem? (3)

Answer 10

• Medulla
• Pons
• Midbrain

Question 11

Main brainstem stroke symptoms?

Answer 11

If MEDULLA affected (most common)
--- "DANVAH"
If MIDBRAIN affected
---contralateral weakness, ipsilateral oculomotor nerve palsy
If PONS affected
---locked in syndrome

Question 12

DANVAH in brainstem stroke (medulla)

Answer 12

Dyshpagia (contralateral)
Ataxia (ipsilateral)
Nystagmus
Vertigo
Anaesthesia
Horner's syndrome