SCRN EXAM REVIEW 2024/2025 QUESTIONS WITH LATEST
SOLUTIONS GRADED A+
Posterior Cerebral Artery (PCA) - ANSWER-Arises from basilar. Supplies Occipital Lobe
, Midbrain, Thalamus, Pineal Gland, Choroid Plexus, and Corpus Callosum
Symptoms of PCA Stroke - ANSWER--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) - ANSWER-Feeds anterior inferior parts of the
cerebellum
Symptoms of AICA Stroke - ANSWER-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) - ANSWER-Feeds cerebellum, superior
section of the medulla,. Choroid plexus and fourth ventricle
Symptoms of PICA Stroke - ANSWER-Wallenburg Syndrome (lateral Medullary
Syndrome): Loss of pain and temperature sensation in the contralateral trunk and
ipsilateral face
Basilar Artery - ANSWER-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 - ANSWER-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) - ANSWER-Feeds the media portion of the frontal and
parietal lobes as well as the corpus callosum
Symptoms of ACA Stroke - ANSWER-Contralateral motor/sensory deficits impacting
legs > arms
,Middle Cerebral Artery (MCA) - ANSWER-Feeds majority of the frontal, parietal, and
temporal lobes, basal ganglia, internal capsule. It is divided M1 - M4
Symptoms of MCA Stroke - ANSWER--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 - ANSWER-Venous channels enter into venous sinuses
located in the Dura matter.
Superior Sagittal Sinus - ANSWER-Travels posteriorly between the cerebral
hemispheres towards the occiput
Straight Sinus - ANSWER-Travels along the tentorium, draining blood from the superior
cerebellar veins.
Transverse Sinus - ANSWER-Travels along the base of the occiput laterally and
forwardly
Sigmoid Sinus - ANSWER-Begins beneath the temporal bone and travels to the jugular
foramen where it becomes the internal jugular veins
Stroke Pathophysiology - ANSWER-Arterial blood flow to the brain tissue fails to meet
metabolic demands resulting in cell damage or death. ISCHEMIA FIRST THEN
INFARCT.
Penumbra - ANSWER-Zone surrounding the core infarct, damaged by ischemia but not
yet infarcted
---- functionally silent yet metabolically active
Hypoxia leading to Necrotic Pathway - ANSWER-Cell energy failure
Hypoxia leading to Apoptotic Pathway - ANSWER-Programmed cell death in the
penumbral zone
ICH Stroke Pathophysiology - ANSWER-Occurs when a cerebral blood vessel opens
abnormally and spills blood into brain tissue.
Classification of ICH Brain Injury - ANSWER-Primary Brain Injury: Direct result of the
hematoma
Secondary Brain Injury: Hours or days after ICH, mass effect causes mechanical
disruption and damage to cell membranes
, SAH Stroke Pathophysiology - ANSWER-Aneurysm from s in the cerebral vasculature
and ruptures, resulting in blood spilling in the subarachnoid space
Saccular Aneurysm - ANSWER-narrow neck, widened dome -- Most Common
Fusiform Aneurysm - ANSWER-Outpouching of the vessel without a distinct neck ---
Less common
Early Brain Injury - ANSWER-Hours and first several days after aneurysm rupture
cerebral edema forms, injury results from decreased cerebral blood flow
Cerebral Vasospasm (Delayed Cerebral Injury) - ANSWER-Large Vessel Spasm
generally begins on day 4 continues up to 21 days
Brain Requirements - ANSWER-20% of the body's Oxygen
15% of the body's Cardiac Output
Cerebral Blood Flow - ANSWER-Normal: 50 - 55 mL/100g/min
Oligemia: 30 - 40 mL/100g/min
Moderate Ischemia (the penumbra): 20 - 30 mL/100 g/min
Severe ischemia and Cell Death: 0 - 10 mL/100 g/min
Large Vessel occlusion - ANSWER-Embolic: develop elsewhere and travel to blood
vessel in the brain
Small Vessel Occlusion - ANSWER-Thrombotic: caused by a clot that develops in the
vessel of the brain
Cerebral Cortex - ANSWER-Grey matter on the outermost section of the cerebrum and
cerebellum
Divided into four lobes
- Frontal
- Parietal
- Occipital
- Temporal
Frontal Lobe - ANSWER-motor, behavioral expression. Motor/sensory maps
Parietal Lobe - ANSWER-Sensation, optic radiations carrying sensory input from the
eyes, language centers *typically left side of brain*
Language Centers - ANSWER-Broca's: Production/Expressive
SOLUTIONS GRADED A+
Posterior Cerebral Artery (PCA) - ANSWER-Arises from basilar. Supplies Occipital Lobe
, Midbrain, Thalamus, Pineal Gland, Choroid Plexus, and Corpus Callosum
Symptoms of PCA Stroke - ANSWER--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) - ANSWER-Feeds anterior inferior parts of the
cerebellum
Symptoms of AICA Stroke - ANSWER-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) - ANSWER-Feeds cerebellum, superior
section of the medulla,. Choroid plexus and fourth ventricle
Symptoms of PICA Stroke - ANSWER-Wallenburg Syndrome (lateral Medullary
Syndrome): Loss of pain and temperature sensation in the contralateral trunk and
ipsilateral face
Basilar Artery - ANSWER-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 - ANSWER-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) - ANSWER-Feeds the media portion of the frontal and
parietal lobes as well as the corpus callosum
Symptoms of ACA Stroke - ANSWER-Contralateral motor/sensory deficits impacting
legs > arms
,Middle Cerebral Artery (MCA) - ANSWER-Feeds majority of the frontal, parietal, and
temporal lobes, basal ganglia, internal capsule. It is divided M1 - M4
Symptoms of MCA Stroke - ANSWER--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 - ANSWER-Venous channels enter into venous sinuses
located in the Dura matter.
Superior Sagittal Sinus - ANSWER-Travels posteriorly between the cerebral
hemispheres towards the occiput
Straight Sinus - ANSWER-Travels along the tentorium, draining blood from the superior
cerebellar veins.
Transverse Sinus - ANSWER-Travels along the base of the occiput laterally and
forwardly
Sigmoid Sinus - ANSWER-Begins beneath the temporal bone and travels to the jugular
foramen where it becomes the internal jugular veins
Stroke Pathophysiology - ANSWER-Arterial blood flow to the brain tissue fails to meet
metabolic demands resulting in cell damage or death. ISCHEMIA FIRST THEN
INFARCT.
Penumbra - ANSWER-Zone surrounding the core infarct, damaged by ischemia but not
yet infarcted
---- functionally silent yet metabolically active
Hypoxia leading to Necrotic Pathway - ANSWER-Cell energy failure
Hypoxia leading to Apoptotic Pathway - ANSWER-Programmed cell death in the
penumbral zone
ICH Stroke Pathophysiology - ANSWER-Occurs when a cerebral blood vessel opens
abnormally and spills blood into brain tissue.
Classification of ICH Brain Injury - ANSWER-Primary Brain Injury: Direct result of the
hematoma
Secondary Brain Injury: Hours or days after ICH, mass effect causes mechanical
disruption and damage to cell membranes
, SAH Stroke Pathophysiology - ANSWER-Aneurysm from s in the cerebral vasculature
and ruptures, resulting in blood spilling in the subarachnoid space
Saccular Aneurysm - ANSWER-narrow neck, widened dome -- Most Common
Fusiform Aneurysm - ANSWER-Outpouching of the vessel without a distinct neck ---
Less common
Early Brain Injury - ANSWER-Hours and first several days after aneurysm rupture
cerebral edema forms, injury results from decreased cerebral blood flow
Cerebral Vasospasm (Delayed Cerebral Injury) - ANSWER-Large Vessel Spasm
generally begins on day 4 continues up to 21 days
Brain Requirements - ANSWER-20% of the body's Oxygen
15% of the body's Cardiac Output
Cerebral Blood Flow - ANSWER-Normal: 50 - 55 mL/100g/min
Oligemia: 30 - 40 mL/100g/min
Moderate Ischemia (the penumbra): 20 - 30 mL/100 g/min
Severe ischemia and Cell Death: 0 - 10 mL/100 g/min
Large Vessel occlusion - ANSWER-Embolic: develop elsewhere and travel to blood
vessel in the brain
Small Vessel Occlusion - ANSWER-Thrombotic: caused by a clot that develops in the
vessel of the brain
Cerebral Cortex - ANSWER-Grey matter on the outermost section of the cerebrum and
cerebellum
Divided into four lobes
- Frontal
- Parietal
- Occipital
- Temporal
Frontal Lobe - ANSWER-motor, behavioral expression. Motor/sensory maps
Parietal Lobe - ANSWER-Sensation, optic radiations carrying sensory input from the
eyes, language centers *typically left side of brain*
Language Centers - ANSWER-Broca's: Production/Expressive
