SCRN EXAM REVIEW 2024 QUESTIONS AND ANSWERS GRADED A 2024

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 (lateral Medullary Syndrome): Loss of pain and temperature sensation in the contralateral trunk and ipsilateral face 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. Symptoms of Basilar Artery Stoke - Coma, quadriparesis, ataxia, dysarthria, CN dysfunction and visual deficits, Locked in Syndrome, Intranuclear Opthalmoplegia, gaze paresis, Millard Gulber Syndrome CN VI VII damage (diplopia facial weakness, loss of corneal reflex), Nausea, vomiting, diplopia, gaze palsy, dysarthria,. vertigo, tinnitus, hemiparesis, and quadriplegia. Anterior Cerebral Artery (ACA) - Feeds the media portion of the frontal and parietal lobes as well as the corpus callosum Symptoms of ACA Stroke - Contralateral motor/sensory deficits impacting legs > arms Middle Cerebral Artery (MCA) - Feeds majority of the frontal, parietal, and temporal lobes, basal ganglia, internal capsule. It is divided M1 - M4 Symptoms of MCA Stroke - -Aphasia if dominant hemisphere -Neglect if non-dominant hemisphere -Contralateral motor/sensory loss of face/arm/leg with Arms > Legs -Anosognosia: neglect or lack of self awareness Venous Vascular Anatomy - Venous channels enter into venous sinuses located in the Dura matter. Superior Sagittal Sinus - Travels posteriorly between the cerebral hemispheres towards the occiput Straight Sinus - Travels along the tentorium, draining blood from the superior cerebellar veins. Transverse Sinus - Travels along the base of the occiput laterally and forwardly Sigmoid Sinus - Begins beneath the temporal bone and travels to the jugular foramen where it becomes the internal jugular veins Stroke Pathophysiology - Arterial blood flow to the brain tissue fails to meet metabolic demands resulting in cell damage or death. ISCHEMIA FIRST THEN INFARCT. Penumbra - Zone surrounding the core infarct, damaged by ischemia but not yet infarcted ---- functionally silent yet metabolically active Hypoxia leading to Necrotic Pathway - Cell energy failure