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Neuro - Blood Supply and Lesions Lecture
Terms in this set (24)
The deep branches of the ACA supply what structures?
Head of the caudate
Anterior portion of the internal capsule
The surface branches of the ACA supply what structures?
Inferior surface of frontal lobe
Medial surfaces of frontal and parietal lobes
Anterior portion of the corpus callosum
The deep branches of the MCA supply what?
Posterior limb of the internal capsule
Body of the caudate
The surface branches of the MCA supply what?
Most of the convexity of each hemisphere
Underlying subcortical white matter
What do the vertebral arteries pass through to enter the skull? At what level (or landmark)?
The deep branches of the PCA supply what?
Parts of the thalamus
Parts of the midbrain
The surface branches of the PCA supply what?
Inferior surfaces of the temporal and occipital lobes
Posterior corpus callosum
What levels of the spinal cord are only supplied by one radicular artery and are therefore susceptible to vascular insult?
What do the internal carotid arteries pass through to enter the skull?
An occlusion to one or more of the surface arteries of the ACA may produce:
Unilateral lesion (contralateral hemiparesis and hemi sensory loss of LE or bilateral lesion (LE paraplegia))
Personality changes, apathy, certain agnosia's (prefrontal association area)
Lesion of cingulated gyrus (limbic system)
An occlusion to one or more of the deep arteries of the ACA may produce:
Motor apraxia --> esp. with bilateral activities (anterior portion of corpus callosum)
An occlusion to one or more of the surface arteries of the PCA may produce:
Blindness or contralateral homonymous hemianopsia (if primary visual cortex affected)
Visual agnosia (if secondary visual cortex affected)
Memory disturbances (inferior temporal lobe)
An occlusion to one or more of the deep arteries of the PCA may produce:
Alexias (damage to posterior corpus callosum --> word blindness)
Contralateral hemisensory loss or thalamic pain syndrome (damage to thalamus)
What is anterior circulation of the Circle of Willis derived from?
Internal carotid arteries
What is posterior circulation of the Circle of Willis derived from?
What are the deep branches of the MCA?
What deep branch of the MCA is most susceptible to damage from HTN? Why?
Branch off MCA at a 90 degree angle
An occlusion of one or more superficial branches of the MCA (depending on the site) may produce:
Contralateral hemiplegia and/or hemisensory loss of UE and face
Auditory deficit (worse in ear contralateral to lesion)
Abnormal eye gaze (damage to frontal eye field; eye deviates toward the side of injury)
Higher-order loss (APRAXIA with prefrontal or PTO assault; APHASIA with Broca's or Wernicke's assault; NEGLECT if right hemisphere affected)
An occlusion of one or more penetrating branches of the MCA may produce:
Contralateral homonymous hemianopsia/quardrantopsia (damage to optic radiation/Meyer's loop)
Parkinson's-like symptoms (anterior choroidal and lenticulostriate branches of MCA affected)
Contralateral hemiplegia/hemisensory loss without higher-order defects (damage to internal capsule)
What is the semicircular strip of cortex representing the boundary between territories of the 3 major cerebral arteries (AKA no man's zone)?
What makes the cerebral watershed a "no man's zone"?
Poor blood perfusion
Most sensitive to cerebral hypoxia and eventually infarcts
What vessels make up the vertebral-basilar arterial complex?
Basilar artery: pontine arteries, anterior and superior cerebellar arteries
Vertebral artery: anterior and posterior spinal arteries, posterior cerebellar artery
What area(s) does the vertebral-basilar arterial complex supply?
Small portions of the occipital lobe
Brainstem (pons & medulla)
What symptoms may be produced by a vascular insult to the vertebral-basilar arterial complex?
"Long tract" signs (damage to axons of spinal tracts passing through brainstem) --> contralateral hemiplegia or bilateral quadriplegia motor & sensory deficits
"Alternating" signs --> contralateral lim/trunk sx with ipsilateral CN sx (i.e. - medial and lateral medullary syndromes)
Reticular formation --> coma
"Bulbar" signs --> CN involvement sx
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