Stroke Flashcards

Arteries of the head and neck
Terms Definitions
MCA Syndrome: When main stem is completely blocked
• CL hemiplegia (esp. UE)
• CL hemianesthesia
• CL homonymous hemianopsia
• Head and eye turning toward lesion
• Dysphagia
• Uninhibited bowel and bladder function
MCA Syndrome: main stem of dominant hemisphere
• Global aphasia: loss of fluency, ability to name objects, comprehend auditory information, and repeat
• Ideomotor apraxia: movements are dyskinetic in response to commands, know objects but can not sequence movements to use object
MCA Syndrome: main stem of non-dominant hemisphere
• Agnosia (inability to recognize/name objects, etc.)
• Unilateral neglect: usually L body
• Apraxia
• Visuospatial disorders: inability to judge distance or spatial relations
MCA Syndrome: Superior branch of MCA
• Broca’s aphasia (expressive)
• Motor speech impairment, difficulty or inability to find words and to express language smoothly, pt is aware and frustrated
MCA Syndrome: Inferior division of MCA in dominant hemisphere
• Wernicke’s aphasia (receptive): verbal speech may not make sense, pt unaware of deficit, fluent
MCA Syndrome: Inferior division of MCA in non-dominant hemisphere
• Spatial agnosia without weakness or
• Hemiplegia
Anterior Cerebral Artery (ACA) Syndrome
• CL hemiparesis
• CL hemianasthesia
• Abulia (loss of ability to act indep. Make decisions)
• CL UE paresis
• Urinary incontinence
• Perserveration and amnesia
Internal carotid artery (ICA) Syndrome
o Syndrome varies due to cause of ischemia
o Most often the cortex which is supplied by the MCA is most affected
o At times the origin of both MCA and ACA are occluded at the top of carotid artery
o May have symptoms of both MCA and ACA syndromes
o Can also be asymptomatic due to collateral supply
Posterior Cerebral Artery (PCA) Syndrome: Central Blockage
• Thalamic syndrome: abnormal sensation of pain, temp, proprioception and touch
• CL hemiplegia
• CL ataxia
• 3rd nerve palsy: paresis of vertical eye movements, sluggish pupillary reaction to light
• postural tremors
• hemiballismus: flailing of extremities
• if subthalamus: decerebrate rigidity and coma
Posterior Cerebral Artery (PCA) Syndrome: Peripheral Blockage
• Homonymous hemianopsia, deficit is on side opposite of lesion, can also be bilateral
• Cortical blindness, optic nerve and tract intact but no image is recorded
• Ocular apraxia
• Memory deficits
• Topographic disorientation
• Alexia without agraphia, if dominant hemisphere damaged, impaired reading with normal writing
• Agnosia, difficult in recognizing faces, objects, colors, etc
• Anomia, inability to identify objects by name
Vertebral Artery (VA) Syndrome: PICA
• Wallenberg syndrome/lateral medullary syndrome
• Most common vascular syndrome of brainstem
• Often occurs with occlusion of PICA
Basilar Artery (BA) Syndrome
• Tracts affected:
• Corticospinal and corticobulbar
• Spinothalamic
• Medial and superior cerebellar peduncles
• Cranial nerve nuclei

o At least 8 syndromes that vary in clinical presentations of:
• Optic paralysis
• Face, trunk, and extremity paralysis
• Ataxia
• Sensory loss

o “Locked In” syndrome (complete paralysis of all voluntary mm except eyes)
o Complete basilar syndrome:
• BL long tract signs cerebellar and CN abnormalities
• Coma
• Quadriplegia
• Pseudobulbar palsy
• Nearly a complete ischemic transection of brainstem
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