Glossary of Neuro - Blood Supply
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- List the arteries that branch off the vertebral/basilar arteries from caudal to rostral.
- PICA (off vertebral) w/anterior spinal arteries joining medially, AICA, pontine arteries, SCA,(CNIII), PCA
- What supplies the anterior 2/3 of the spinal cord?
- anterior spinal arteries
- What region does PICA supply?
- dorsolateral medulla (dorsal to inf olive
- What region does AICA supply?
- Inferior cerebellum, cerebellar nuclei, ventrolateral caudal pons
- What region does SCA supply?
- dorsal cerebellar hemispheres, sup cerebellar peduncle
- What region does PCA supply?
- Major midbrain supplier, thalamus, occipital lobe (including visual cortex and hippocampal formation)
- What region does ACA supply?
- medial aspect of frontal and parietal lobes (primary motor and sensory cortex - leg/foot)
- What region does MCA supply?
- outer cortical: lateral surface of frontal, parietal, upper temporal lobes
lenticulostriate (deep): internal capsule, caudate, putamen, globus pallidus
- What is the most common site of aneurysm in the Circle of Willis and what sx does it cause?
- AComm; bitemporal lower quadrantopia
- What is the second most common site of aneurysm in the Circle of Willis, and what sx does it cause?
- PComm; third nerve palsy
- What are the deficits that result from ACA blockage?
- contralateral spastic paralysis and anesthesia of lower limb, and frontal lobe abnormalities
- What deficits result from PCA occlusion?
- contralateral hemianopia w/macular sparing
- What deficits result from MCA occlusion?
- Contralateral spastic paralysis and anesthesia of upper limb/face, GAZE PALSY, aphasia and Gerstmann syndrome if in dominant hemisphere, hemi-inattention and neglect of contralateral body (if in parietal lobe)
- What syndrome results from anterior spinal artery occlusion?
- Medial Medullary Syndrome
- What are the deficits in Medial Medullary Syndrome?
- Pyramid: contralateral spastic paresis
Medial lemniscus: contralateral loss of touch, pressure, proprioception for body
CN XII: ipsilateral flaccid hemiparalysis of tongue (points toward lesion)
- What syndrome results from PICA occlusion?
- Lateral Medullary Syndrome (aka Wallenberg Syndrome)
- What are the symptoms of Lateral Medullary Syndrome?
- Inferior cerebellar peduncle: ipsilateral cerebellar signs (dystaxia, dysmetria(past pointing), dysdiadochokinesia(lightbulb))
Vestibular nuclei: vertigo, nystagmus (away from lesion), nausea/vomiting
Nucleus ambiguus (CN IX, X, XI): ipsilateral paralysis of larynx, pharynx, palate -> dysarthria, dysphagia, loss of gag reflex
Spinal Nuc and Tract of V: ipsilateral pain and temperature loss of face
Spinothalamic tracts: ipsilateral pain and temperature loss of body
Descending hypothalamics: ipsilateral Horner's syndrome (ptosis, miosis, anhidrosis, enophthalmos)
- What syndrome results from AICA occlusion?
- Lateral Pontine Syndrome
- What are the symptoms of Lateral (inferior) Pontine Syndrome?
- Facial nucleus/fibers: ipsilateral facial paralysis; loss of taste (ant 2/3), lacrimation, salivation, and corneal reflex; hyperacusis (acute hearing)
Cochlear nuclei/VIII fibers: ipsilateral hearing loss
Middle cerebellar peduncle: ipsilateral limb/gait dystaxia
Vestibular nuclei: vertigo, nausea/vomiting, nystagmus
Spinal nuc/tract of V: ipsilat pain/temp loss (face)
ipsilat pain/temp loss (body)
Descending sympathetics: ipsilateral Horner's syndrome
- What syndrome results from occlusion of the paramedian branches of the basilar artery?
- Medial (inferior) Pontine Syndrome
- What are the sx of Medial (inferior) Pontine Syndrome?
- Corticospinal tract: contralateral spastic hemiparesis
Medial lemniscus: contralateral loss of touch/press/position sense on body
Fibers of CN VI: ipsilateral lateral rectus paralysis (medial strabismus)
- Sx of Dorsal Midbrain (Parinaud) Syndrome?
- (tumor in pineal region)
Superior colliculus/pretectal area: paralysis of upwards (and downwards) gaze, pupillary disturbances, no convergence
Cerebral aqueduct: noncommunicating hydrocephalus
- What syndrome results from occlusion of branches of PCA?
- Medial Midbrain (Weber) Syndrome
- Sx of Medial Midbrain (Weber) Syndrome?
- Fibers of CN III: ipsilateral oculomotor palsy (down and out, ptosis, fixed and dilated pupil)
Corticospinal tract: Contralateral spastic hemiparesis
Corticobulbar fibers: contralateral spastic hemiparesis of face (forehead spared) (uvula and palate are pulled to normal side, tongue points to weak side)
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