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WorksheetsStroke 1
Total questions: 25
Worksheet time: 25mins
What structures do the PCA's supply?
Upper brainstem, inferior parts of the temporal lobe, medial parts of the occipital lobe
Lower brainstem, inferior parts of the temporal lobe, lateral parts of the occipital lobe
Upper brainstem, inferior parts of the temporal lobe, lateral parts of the occipital lobe
Lower brainstem, inferior parts of the temporal lobe, medial parts of the occipital lobe
What is transcortical sensory aphasia?
Not fluent, Can Comprehend, Can't Repeat
Fluent, Can't Comprehend, Can't Repeat
Fluent, Can't Comprehend, Can Repeat
Not fluent, Can't Comprehend, Can't Repeat
The cerebellum is supplied by which three arteries?
PICA, AICA, and SCA
PICA, AICA, and ICA
PICA, PICA, PIKACHU
AICA, SCA, and ICA
Vertebrobasilar system strokes often present with what signs/symptoms?
Vertigo, nystagmus, facial droop, aphasia
Nausea, vomiting, cognitive deficits
Motor or sensory deficit on ipsilateral face and contralateral body (Crossed Signs), as well as nystagmus, and aphasia
Crossed signs, vertigo, nystagmus, ipsilateral CN dysfunction
The vertebral arteries originate from the (blank) and are the main arteries of the (blank)?
Internal carotid arteries; medulla
Subclavian arteries; medulla
Subclavian arteries; pons
Basilar artery; pons
What is the presentation of Medial Medullary Syndrome?
ipsilateral abducens (CN6) and facial (CN7 palsies) contralateral hemiplegia, analgesia, hypoesthesia
ipsilateral CN3 paralysis, contralateral hemiplegia, contralateral parkinson signs, contralateral dystaxia (mild degree of ataxia)
ipsilateral hypoglossal palsy (deviation toward side of lesion), contralateral hemiparesis, contralateral lemniscal sensory loss (proprioception and position sense)
contralateral CN6 and CN8 paralysis, contralateral hemiplegia, and contralateral ataxia
What is the most common site of intracranial hemorrhage?
Pons
Putamen
Thalamus
Cerebrum
Cerebellum
What presentation would be seen with an ICH involving the Putamen?
hemiplegia, contralateral sensory deficits, aphasia (if lesion on dominant side) vs contralateral hemineglect (if lesion on nondominant side)
hemiplegia, vomiting, stupor/coma (if large), HA leading to aphasia, eyes deviate away from paretic limbs
Coma/LOC, unusual vomiting, occiptal HA, vertigo, inability to sit, stand, or walk; eyes deviate to opposite side (ipsilateral CN6 palsy), dysarthria, dysphagia
Deep coma within minutes, total paralysis, small but reactive pupils, decerebrate rigidity (tends to be fatal in few hours)
Occlusion of what artery would cause a patient to have tetraparesis and horizontal gaze palsy?
Anterior inferior cerebellar artery
Basilar artery
Posterior inferior cerebellar artery
Anterior spinal artery
What is the most common location of a saccular aneurysm?
Anterior Circle of Willis
Posterior Circle of Willis
Posterior inferior cerebellar artery
Vertebral Arteries
Which of the following areas is most likely to be affected by an insult to the anterior cerebral artery?
Finger flexors
Finger extensors
Ankle dorsiflexors
Muscles of mastication
Larynx
Cerebrospinal fluid is produced by
ependymal cells
dendritic cells
radial glial cells
microglia
oligodendrocytes
Which of the following areas would produce the most distal occlusion to CSF flow?
lateral ventricles
fourth ventricle
aqueduct of Sylvius
foramina of Monro
third ventricle
Which of the following areas is most likely to be affected by an insult to the middle cerebral artery?
Extensor hallicus longus
Hip flexors
Lumbar paraspinals
Genitalia
Finger flexors
Which type of headache corresponds to an increased risk of stroke?
Tension
Cluster
Migraine
Medication Overuse
How does distal ICA occlusion present?
Always symptomatic
only MCA distribution
only ICA distribution
Contralateral motor and/or sensory symptoms
Which of the following is not true of stroke involving superior division of MCA?
Most common cause of occlusion is embolus
head and eyes deviated toward side of lesion
Transient LOC is common
dominant sided lesion sees global aphasia initially then turns into Broca's
What type of stroke often has pure motor or pure sensory syndromes?
ICA occlusion
hemorrhagic
MCA stroke
Lacunar stroke
What type of stroke often occurs during sleep and patient awakens unaware of deficits?
thrombotic
embolic
hypertensive ICH
Subarachnoid hemorrhage
Which of the following is true regarding hypertensive ICH?
most commonly during strenuous activity
most commonly occurs when patient is calm and unstressed
whites > blacks
>10% have preceding TIA
The most common location of a subarachnoid hemorrhage arising from a ruptured saccular arterial aneurysm is
Posterior Circle of Willis
Anterior Circle of Willis
Posterior Communicating Artery
Anterior Communicating Artery
35yo F presents with sudden transient LOC, right hemiparesis, and ataxia, with possible seizure like activity. Head imaging reveals subarachnoid hemorrhage. What is her expected mortality in the first 24 hours?
<5%
10%
25%
45%
35yo F presents with sudden transient LOC, right hemiparesis, and ataxia, with possible seizure like activity. Head imaging reveals subarachnoid hemorrhage. She is treated, stabilized, and admitted to IPR. What is her risk of rebleeding within 1 month?
15%
30%
45%
70%
A 30yo M presents with sudden onset of severe headache, a dilated left pupil that is deviated to the lateral side. Imaging reveals a subarachnoid hemorrhage. Which cranial nerve is likely compressed?
Left CN 6
Right CN 6
Left CN 3
Right CN 3
A patient presents with a known history of maternal arteriovenous malformations, and asks what the most common initial presentation would be in her, a patient with no known history. You reply,
A seizure
A sentinel headache
A hemorrhage
Ataxia
