Strokes

Question 1

Middle Cerebral Artery

Answer 1

• Motor and sensory cortices of upper limb/face –> contralateral paralysis and sensory loss
• Wernicke & Broca
• Aphasia if dominant side and hemineglect if non-dominant side

Question 2

Anterior Cerebral Artery

Answer 2

-Motor and sensory cortices of lower limb –> contralateral paralysis and sensory loss

Question 3

Lenticulostriate Artery

Answer 3

• Supplies striatum and internal capsule
• Have contralateral paralysis and/or sensory loss BUT no cortical signs (like neglect, aphasia, visual field loss)
• Seen in lacunar infarcts

Question 4

Anterior Spinal Artery

Answer 4

MEDIAL MEDULLARY SYNDROME

• Medullary Pyramids –> contralateral paralysis
• Medial lemniscus –> lose contralateral proprioception
• Caudal medulla (hypoglossal nerve) –> tongue deviates to side of lesion

Question 5

PICA

Answer 5

LATERAL MEDULLARY SYNDROME (wallenberg)

• Nucleus ambiguus –> dysphagia, hoarse, no gag
• Vestibular nuclei –> vomit, vertigo, nystagmus
• Lateral spinothalamic and trigeminal nucleus –> dec pain/temp from contralateral body and ipsilateral face
• Sympathetic fibers –> ipsilateral Horner
• Inferior peduncles –> ataxia, dysmetria

Question 6

AICA

Answer 6

LATERAL PONTINE SYNDROME

• Lateral pons/facial nucleus –> paralysis of face, dec lacrimation, dec salivation, dec anterior 2/3 taste
• Vestibular nuclei –> vomiting, vertigo, nystagmus
• Lateral spinothalamic and trigeminal nucleus –> dec pain/temp from contralateral body and ipsilateral face

–Sympathetic fibers –> ipsilateral Horner

-Middle and inferior peduncles –> ataxia, dysmetria

Question 7

Basilar

Answer 7

LOCKED-IN SYNDROME

• Pons/medulla/lower midbrain –> RAS spared so conscious
• Corticospinal and corticobulbar tracts –> quadriplegia, loss of voluntary facial, tongue and mouth movements
• Ocular cranial nerve nuclei, paramedian pontine reticular formation –> horizontal but not vertical eye movements are lost

Question 8

Posterior Cerebral Artery

Answer 8

-Supplies occipital lobe –> contralateral hemianopia w/ macular sparing