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Stroke Syndromes
| Question | Answer |
|---|---|
| Risk Factors for Stroke ? | * Hypertension -- Atrial fibrillation -- Diabetes mellitus -- Smoking -- Hyperlipidemia -- Asymptomatic carotid stenosis -- Symptomatic carotid stenosis |
| Anterior circulation = ? | * Internal carotid branches -- Middle Cerebral Artery -- Anterior Cerebral Artery |
| If a thrombus makes its way up the internal carotid artery ? | * Patent Circle of Willis is protective, and get the same CxSx as MCA syndrome |
| ACA & MCA occlusion CxSx ? | * Abulia (lack of motivation) -- Stupor -- Hemiplegia -- Hemianesthesia -- Aphasia or anosognosia |
| Occlusion of Ophthalmic artery to retina and optic nerve = ? | * recurrent transient monocular blindness (amaurosis fugax) & horizontal shade across vision |
| If Common Carotid becomes occluded ? | * same as internal carotid |
| External carotid occlusion = ? | * Jaw claudication |
| Bilateral common carotid artery occlusions = ? | * Takayasu’s Arteritis |
| Middle Cerebral Artery (MCA)emboli CxSx = ? | * Contralateral upper extremity hemiplegia, hemianesthesia, and Homonymous hemianopsia.... * Global aphasia if dominant hemisphere .... * Anosognosia , constructional apraxia & neglect if non- dominant hemisphere |
| MCA Partial Occlusions ? | * Frontal Opercular syndrome = Nonfluent (Broca) expressive aphasia (know what ppl are saying, but can't respond) |
| If Proximal superior division occlusion of MCA ? | * Nonfluent aphasia (Broca’s aphasia) |
| If Inferior division occlusion of MCA ? | * Fluent (Wernicke’s) receptive aphasia |
| MCA - Lenticulostriate Occlusions ? | * Lacunar Stroke In Internal Capsule = someone with high BP/HTN and see Facial Weakness followed by Arm to Leg Weakness as infarct moves anteriorly to posteriorly |
| Anterior Cerebral Artery (ACA) proximal occlusion = ? | * well tolerated due to collaterals from anterior communicating artery, MCA and PCA |
| Postcommunal segment ACA Occlusion of single segment = ? If bilateral ? | * One segment = contralateral symptoms...... * Bilateral = Both hemispheres affected |
| Artery that can become occluded during surgery for repair of aneurysm of internal carotid and CxSx with it ? | * Anterior Choroidal Artery.... * See Contralateral hemiplegia, hemianesthesia (hypesthesia, and Homonymous hemianopsia |
| PCA Syndromes - P1 syndromes ? | * Infarction in ipsilateral subthalamus & medial thalamus and Infarction in ipsilateral cerebral peduncle & midbrain |
| P2 Syndromes ? | * Infarction of medial temporal & occipital lobes |
| P1 syndrome CxSx = ? | * Subthalamic nucleus = contralateral Hemiballismus (movement disorder that prevents day-to-day activities)...... * Ataxia = red nucleus and Hemiplegia = cerebral peduncle involvement |
| P1 Syndrome - Occlusion of bilateral proximal PCA ? | * Coma, Unreactive pupils, and Decerebrate rigidity |
| P1 Syndrome - Occlusion of penetrating branches of thalamic & thalamogeniculate arteries ? | * Agonizing searing or burning pain in affected areas |
| P2 Syndromes - Occlusion of DISTAL PCA = ? | * Infarct of calcarine cortex = Patient is aware of visual defects.....* Infarct of medial temporal lobe & hippocampus = Acute disturbances in memory if in dominant hemisphere.....* Peduncular Hallucinosis = visual halluc. of colored scenes & objects |
| P2 Syndromes - Bilateral PCA occlusions = ? | * Cortical blindness with preserved pupillary light reactions |
| P2 Syndromes - Embolus of top of basilar artery ? | * Sudden onset of bilateral signs: Ptosis , Pupillary assymmetry , Lack of reaction to light |
| Vertebral Artery - Atherosclerosis in V1 and V4 ? | * Stenosis proximal to posterior inferior cerebellar artery (PICA) --> Threatens medulla and posterior inferior cerebellum |
| Vertebral Artery - Atherosclerosis in V2 & V3 ? | *Wallenberg’s Syndrome = Lateral medulla ischemia due to V4 occlusion --> Vertigo, numbness of ipsilateral face & contralateral limbs, diplopia, hoarseness, dysarthria, dysphagia, ipsilateral Horner’s syndrome ...* Story was a girl sneezed and had this |
| Posterior Inferior Cerebellar Artery (PICA) - Medial medullary syndrome = ? | * Contralateral hemiparesis of arm & leg (sparing face) -- Contralateral impaired tactile & proprioceptive sense -- Ipsilateral paralysis with atrophy of ½ of tongue ( NOT Face) |
| Occlusion of anterior spinal artery ? | * quadraparesis |
| Basilar Artery - Complete basilar occlusion ? | * “Locked in” syndrome -> preserved consciousness, quadriplegia, cranial nerve signs |
| Cerebellar Arteries - Superior cerebellar artery occlusion ? | * Severe cerebellar ataxia, nausea & vomiting, dysarthria, contralateral loss of pain and temperature sensation in extremities, body & face |
| Cerebellar Arteries - Anterior Inferior Cerebellar artery occlusion ? | * Ipsilateral deafness, facial weakness ... * basically see everything like in Superior, but in this one we see weakness, unlike Superior where we only see stumbling, not weakness |
Created by:
thamrick800
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