Flashcards in Blood Supply Of The Cerebrum Deck (16)
What areas of the brain does the anterior cerebral artery supply (ACA)?
1. Anterior FRONTAL lobe
2. Medial surface of FRONTAL and PARIETAL lobes
What areas of the brain does the Middle cerebral artery supply (MCA)?
1. Most of the outer cerebrum
2. Basal ganglia
3. Posterior and anterior internal capsule
6. Lentiform nucleus
What areas of the brain does the Posterior cerebral artery supply (PCA)?
1. Portion of midbrain
2. Subthalamic nucleus
3. Basal nucleus
5. Inferior temporal lobe
6. Occipital and occipitoparietal cortices
What areas of the brain does the vertebral-basilar artery supply?
1. LATERAL aspect of the PONS and MIDBRAIN together with SUPERIOR surface of CEREBELLUM
2. Cerebellum- branches from the basilar artery (posterior inferior cerebellar, anterior inferior cerebellar, and superior cerebellar arteries)
3. Medulla- posture inferior cerebellar artery, smaller branches from the vertebral arteries
4. Pons-branches form the basilar artery
5. Midbrain and thalamus-posterior cerebral arteries
6. Occipital cortex- posterior cerebral artery, basilar artery
What are the possible expected outcomes of a ACA lesion?
1. CONTRALATERAL LE motor and sensory involvement
2. Loss of B&B
3. Loss of behavioral inhibition
4. Significant mental changes
5. Significant mental changes
8. Apraxia and agraphia
10. Akinetic mutism w/ significant bilateral involvement
What are some possible impairments that may occur with a MCA lesion?
1. Most common site of CVA*****
2. Wernicke’s aphasia in dominant hemisphere
3. Homonymous hemianopsia
5. Flat affect w/ R hemisphere damage
6. CONTRALATERAL weakness + sensory loss of face and UE w/ lesser involvement in the LE
7. Impaired spatial relations
8. Agnosognosia in non-dominant hemisphere
9. Impaired body schema
What are some expected possible impairments that may occur with a PCA lesion?
1. CONTRALATERAL pain and temperature sensory loss
2. CONTRALATERAL hemiplegia (central area), mild hemiparesis
3. Ataxia, athethosis or choreiform movement
4. Quality of movement is impaired
5. Thalamic pain syndrome
7. Prosopagnosia with occipital infarct
9. Visual agnosia
10. Homonymous hemianopsia
11. Memory impairment
12. Alexia, dyslexia
12. Cortical blindness from bilateral involvement
What are some expected possible impairments that may occur with a Vertebral-basilar artery lesion?
1. Loss of consciousness
2. Hemiplegia or tetraplegia
3. Comatose or vegetative state
4. Inability to speak
5. Locked-in syndrome
What will typically produce the most significant impairments?
Bilateral arterial involvement in the brain
What will bilateral occlusion of the ACA produce?
2. Abulic aphasia
3. Frontal lobe symptoms (personality changes, potential akinetic mutism (i.e. conscious unresponsive ness)
What will bilateral occlusion of the MCA at the stem produce?
Contralateral hemiplegia (commonly where CVA’s occur) and sensory impairment
What are dominant hemisphere impairments when the MCA is occluded or hemorrhaged?
Global, Wernicke’s or Broca’s Aphasia
What are the two most significant impairments with an occluded PCA?
1. Thalamic Pain Syndrome
2. Cortical Blindness
How does thalamic pain present?
Abnormal sensation of pain, temperature, touch and proprioception.
The perceived pain can become debilitating
What is cortical blindness due to when secondary to occluded PCA?
Due to damage to the visual portion of the occipital cortex.
Although the affected eye is physically normal, there is full or partial vision loss.
Pupil continues to dilate and constrict in response to light since this occurs w/o influence of the brain