SCRN EXAM REVIEW 100% ACCURATE.
Posterior Cerebral Artery (PCA) - ANSWERArises 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) - ANSWERFeeds anterior inferior parts of the
cerebellum
Symptoms of AICA Stroke - ANSWERLateral 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) - ANSWERFeeds cerebellum, superior
section of the medulla,. Choroid plexus and fourth ventricle
Symptoms of PICA Stroke - ANSWERWallenburg Syndrome (lateral Medullary
Syndrome): Loss of pain and temperature sensation in the contralateral trunk and
ipsilateral face
Basilar Artery - ANSWERAn 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 - ANSWERComa, 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) - ANSWERFeeds the media portion of the frontal and
parietal lobes as well as the corpus callosum
Symptoms of ACA Stroke - ANSWERContralateral motor/sensory deficits impacting
legs > arms
,Middle Cerebral Artery (MCA) - ANSWERFeeds 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 - ANSWERVenous channels enter into venous sinuses
located in the Dura matter.
Superior Sagittal Sinus - ANSWERTravels posteriorly between the cerebral
hemispheres towards the occiput
Straight Sinus - ANSWERTravels along the tentorium, draining blood from the superior
cerebellar veins.
Transverse Sinus - ANSWERTravels along the base of the occiput laterally and
forwardly
Sigmoid Sinus - ANSWERBegins beneath the temporal bone and travels to the jugular
foramen where it becomes the internal jugular veins
Stroke Pathophysiology - ANSWERArterial blood flow to the brain tissue fails to meet
metabolic demands resulting in cell damage or death. ISCHEMIA FIRST THEN
INFARCT.
Penumbra - ANSWERZone surrounding the core infarct, damaged by ischemia but not
yet infarcted
---- functionally silent yet metabolically active
Hypoxia leading to Necrotic Pathway - ANSWERCell energy failure
Hypoxia leading to Apoptotic Pathway - ANSWERProgrammed cell death in the
penumbral zone
ICH Stroke Pathophysiology - ANSWEROccurs when a cerebral blood vessel opens
abnormally and spills blood into brain tissue.
Classification of ICH Brain Injury - ANSWERPrimary 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 - ANSWERAneurysm from s in the cerebral vasculature
and ruptures, resulting in blood spilling in the subarachnoid space
Saccular Aneurysm - ANSWERnarrow neck, widened dome -- Most Common
Fusiform Aneurysm - ANSWEROutpouching of the vessel without a distinct neck ---
Less common
Early Brain Injury - ANSWERHours and first several days after aneurysm rupture
cerebral edema forms, injury results from decreased cerebral blood flow
Cerebral Vasospasm (Delayed Cerebral Injury) - ANSWERLarge Vessel Spasm
generally begins on day 4 continues up to 21 days
Brain Requirements - ANSWER20% of the body's Oxygen
15% of the body's Cardiac Output
Cerebral Blood Flow - ANSWERNormal: 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 - ANSWEREmbolic: develop elsewhere and travel to blood
vessel in the brain
Small Vessel Occlusion - ANSWERThrombotic: caused by a clot that develops in the
vessel of the brain
Cerebral Cortex - ANSWERGrey matter on the outermost section of the cerebrum and
cerebellum
Divided into four lobes
- Frontal
- Parietal
- Occipital
- Temporal
Frontal Lobe - ANSWERmotor, behavioral expression. Motor/sensory maps
Parietal Lobe - ANSWERSensation, optic radiations carrying sensory input from the
eyes, language centers *typically left side of brain*
Language Centers - ANSWERBroca's: Production/Expressive
Posterior Cerebral Artery (PCA) - ANSWERArises 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) - ANSWERFeeds anterior inferior parts of the
cerebellum
Symptoms of AICA Stroke - ANSWERLateral 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) - ANSWERFeeds cerebellum, superior
section of the medulla,. Choroid plexus and fourth ventricle
Symptoms of PICA Stroke - ANSWERWallenburg Syndrome (lateral Medullary
Syndrome): Loss of pain and temperature sensation in the contralateral trunk and
ipsilateral face
Basilar Artery - ANSWERAn 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 - ANSWERComa, 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) - ANSWERFeeds the media portion of the frontal and
parietal lobes as well as the corpus callosum
Symptoms of ACA Stroke - ANSWERContralateral motor/sensory deficits impacting
legs > arms
,Middle Cerebral Artery (MCA) - ANSWERFeeds 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 - ANSWERVenous channels enter into venous sinuses
located in the Dura matter.
Superior Sagittal Sinus - ANSWERTravels posteriorly between the cerebral
hemispheres towards the occiput
Straight Sinus - ANSWERTravels along the tentorium, draining blood from the superior
cerebellar veins.
Transverse Sinus - ANSWERTravels along the base of the occiput laterally and
forwardly
Sigmoid Sinus - ANSWERBegins beneath the temporal bone and travels to the jugular
foramen where it becomes the internal jugular veins
Stroke Pathophysiology - ANSWERArterial blood flow to the brain tissue fails to meet
metabolic demands resulting in cell damage or death. ISCHEMIA FIRST THEN
INFARCT.
Penumbra - ANSWERZone surrounding the core infarct, damaged by ischemia but not
yet infarcted
---- functionally silent yet metabolically active
Hypoxia leading to Necrotic Pathway - ANSWERCell energy failure
Hypoxia leading to Apoptotic Pathway - ANSWERProgrammed cell death in the
penumbral zone
ICH Stroke Pathophysiology - ANSWEROccurs when a cerebral blood vessel opens
abnormally and spills blood into brain tissue.
Classification of ICH Brain Injury - ANSWERPrimary 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 - ANSWERAneurysm from s in the cerebral vasculature
and ruptures, resulting in blood spilling in the subarachnoid space
Saccular Aneurysm - ANSWERnarrow neck, widened dome -- Most Common
Fusiform Aneurysm - ANSWEROutpouching of the vessel without a distinct neck ---
Less common
Early Brain Injury - ANSWERHours and first several days after aneurysm rupture
cerebral edema forms, injury results from decreased cerebral blood flow
Cerebral Vasospasm (Delayed Cerebral Injury) - ANSWERLarge Vessel Spasm
generally begins on day 4 continues up to 21 days
Brain Requirements - ANSWER20% of the body's Oxygen
15% of the body's Cardiac Output
Cerebral Blood Flow - ANSWERNormal: 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 - ANSWEREmbolic: develop elsewhere and travel to blood
vessel in the brain
Small Vessel Occlusion - ANSWERThrombotic: caused by a clot that develops in the
vessel of the brain
Cerebral Cortex - ANSWERGrey matter on the outermost section of the cerebrum and
cerebellum
Divided into four lobes
- Frontal
- Parietal
- Occipital
- Temporal
Frontal Lobe - ANSWERmotor, behavioral expression. Motor/sensory maps
Parietal Lobe - ANSWERSensation, optic radiations carrying sensory input from the
eyes, language centers *typically left side of brain*
Language Centers - ANSWERBroca's: Production/Expressive
