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,Frontal Lobe Motor, personality, Broca Speech
Temporal Lobe Seizure, Wernicke speech, hearing
Parietal Lobe Sensory, right side = NEGLECT
Occipital Lobe vision
Basal Ganglia Coordinates muscle Movement
control voluntary muscle movement
Limbic System neural system (including the hippocampus, amygdala, and hypothalamus) located
below the cerebral hemispheres; associated with emotions and drives.
Hypothalamus functions coordinates Auto NS, body temperature, sleep, appetite, emotions, control of the
pituitary gland
Amygdala manages stress, rage, anxiety, memory and emotions
Cerebellum coordination, balance and fine motor skills
Brain stem functions Cranial nerves
Motor/sensory tracts
Respiratory/Cardiac Center
alert/awake system
Anterior Circulation (UNILATERAL deficits) Internal carotid (Lg vessel) - visual difficulties
ACA (small vessel)- Leg
MCA (small vessel) - arm
Posterior Circulation (BILATERAL deficits) Basilar Artery (Large)
Vertebral arteries (large)
Cerebellar arteries (small)
What is the main function of the Circle of Willis? Provided collateral circulation, common site of aneurysm
How does the Circle of Willis protect the brain? Protects brain from ischemia, preserves cerebral blood flow, determines penumbral
blood flow
Ischemic Stroke Patho - Lack of blood flow--> ischemic cascade --> infarct is ischemia is uncorrected
, Neuronal Cell Death Necrotic - loss of oxygen/glucose from loss of arterial perfusion
Apoptotic - programmed cell death in penumbral zone
Penumbra Darkened tissue around core infarcted area d/t decreased blood flow, tissue is
salvageable
How to save Penumbra Oxygen > 94%
BP < 185/110
Glucose (140-180)
Penumbra Size Factors Speed of stroke onset
occluded vessel diameter
available collateral circulation
ischemia duration
inflammatory response
body temp
metabolic status
ICH Stroke Patho Damage to surrounding tissue and cell death
primary brain injury --> direct pressure
secondary brain injury --> hours to days after ICH, mass effect disrupts cell
membranes, necrosis and cytotoxic edema
Aneurysmal SAH Blood spills into SAH space
aneurysm formation - weak, bulging section of artery
saccular - form at circle of willis
fusiform - without distinct neck, vertobrobasilar location
ICA Stroke Symptoms Visual difficulties
aphasia, neglect, homonymous hemianopsia, motor/sensory loss
Posterior Cerebral Artery (PCA) Arises from basilar. Supplies Occipital Lobe , Midbrain, Thalamus, Pineal Gland,
Choroid Plexus, and Corpus Callosum
Symptoms of PCA Stroke -Contralateral Visual Field Homonymous hemianopia
-Visual Agnosia (unable to interpret/recognize visual information)
- Weber's Syndrome (3rd nerve palsy + contralateral hemiplegia)
-Parinaud's Syndrome (Impaired upwards gaze, convergence-retraction
nystagmus, primary conjugate downward gaze)
Anterior Inferior Cerebellar Artery (AICA) Feeds anterior inferior parts of the cerebellum
Symptoms of AICA Stroke Lateral Pontine Syndrome: vertigo, vomiting, nystagmus, falling towards the side
of the lesion, ipsilateral loss of sensation to the face, ipsilateral facial paralysis,
ipsilateral hearing loss
Posterior Inferior Cerebellar Artery (PICA) Feeds cerebellum, superior section of the medulla,. Choroid plexus and fourth
ventricle
Symptoms of PICA Stroke Wallenburg Syndrome (injury to the spinothalamic tract): Loss of pain and
temperature sensation in the contralateral trunk and ipsilateral face
Horner's syndrome - ipsilateral ptosis, miosis, anhidrosis)
Basilar Artery An artery, formed by the fusion of the vertebral arteries, that supplies blood to the
brainstem (medulla and pons) and to the posterior cerebral arteries.