Cerebrovascular system & stroke

The brain’s two methods of collateral circulation are:

The Circle of Willis and watershed zones

What do the posterior communicating arteries connect?

MCA & ACA

What do the anterior communicating arteries connect?

MCA & PCA

What general areas does the ACA supply?

Orbital & medial surfaces of the frontal & parietal lobes

What structures does the ACA supply?

Medial frontal lobe/motor cortex, SMA, medial sensory cortex, prefrontal cortex, anterior cingulate gyrus

Contralateral leg weakness/paralysis/sensation loss are symptoms of stroke in the:

ACAs

Decreased motivation & executive function, emotional disconnect, and flat affect are symptoms of stroke in the:

ACAs

Difficulty initiating fine, skilled movement (like speech) is a symptom of stroke in:

ACAs

What general areas does the MCA supply?

The lateral surface of either hemisphere

What structures does the MCA supply?

Lateral primary motor, sensory, lang-dominant, & non-lang dominant cortex, and the basal ganglia

Contralateral weakness/paralysis/sensation loss sparing the leg/foot are symptoms of stroke in:

MCAs

Speech/language impairment (apraxia/ataxia) are symptoms of stroke in:

MCAs

Impairment to attention, prosody, and emotion recognition are symptoms of stroke in:

MCAs

Impairments to movement facilitation & inhibition are symptoms of stroke in:

MCAs

What general areas does the PCA supply?

Medial surface of the occipital lobe, inferior surfaces of the occipital and temporal lobes

What structures does the PCA supply?

Thalamus, primary visual cortex, visual association areas, & hippocampus

Contralateral sensory changes (including vision loss/impairment) and visual processing deficits (agnosia, prosopagnosia) are symptoms of stroke in:

PCAs

Memory impairment is a symptom of stroke in the:

PCAs

What structures are supplied by the basilar/vertebral arteries?

Medulla, cerebellum, 4th ventricle, lateral pons, and CNs V, VII, VIII, X

One-sided body weakness (hemiplegia) is a symptom of stroke in the:

basilar/vertebral arteries

Paralysis/weakness and loss of touch, temperature, and pain from the ipsilateral face are symptoms of stroke in the:

basilar/vertebral arteries

Loss of pain/temperature from contralateral limbs & ipsilateral ataxia are symptoms of stroke in the:

basilar/vertebral arteries

Vertigo, rapid unwanted eye movement (nystagmus), and vomiting are symptoms of stroke in the:

basilar/vertebral arteries

Dysphagia, dysarthria, and deafness are symptoms of stroke in:

basilar/vertebral arteries

What connects arteries at watershed zones?

Terminal arteries

Bilateral shoulder/arm weakness is a symptom of stroke at which watershed?

ACA-MCA

Deficits in visual processing, sensory processing, and language comprehension are symptoms of stroke in which watershed zone?

MCA-PCA

Confusion, stupor, cognitive impairment, and delayed awakening from cardiac arrest are symptoms of a:

global stroke

Thrombotic type occlusive strokes occur:

in the brain

Embolic type occlusive strokes occur:

outside of the brain

Thrombotic strokes come on:

gradually

Embolic strokes come on:

suddenlyT

Thrombotic strokes are associated with:

high cholesterol and smoking

Embolic strokes are associated with:

heart conditions

As part of the blood-brain barrier, capillaries are lined INTERNALLY by:

endothelial cells

As part of the blood-brain barrier, capillaries are lined EXTERNALLY by:

astrocyte cells