Stroke and Spinal Cord Syndromes Study Notes

• Study notes on stroke and spinal cord syndromes.

Middle Cerebral Artery (MCA) Stroke

• Results in motor deficits (hemiparesis).
• Can cause communication issues, like aphasia, if the stroke is on the left side of the brain.
• May lead to attention deficits, such as neglect, if the stroke is on the right side of the brain.

Anterior Cerebral Artery (ACA) Stroke

• Causes apathy, characterized by a lack of emotion and slow responses.
• Leads to more weakness in the lower extremities than in the upper extremities.
• Can result in bladder incontinence and balance problems.

Vertebrobasilar Stroke

• Causes vertigo.
• Affects balance, leading to ataxia, dizziness, and clumsiness.
• Causes visual impairments such as double vision and difficulty reading/naming objects.

Wallenberg’s Syndrome

• Causes Ipsilateral Horner’s Syndrome, characterized by sinking of eyeballs, ptosis and a dry, cool face.
• Causes contralateral pain and temperature loss.
• Causes ataxia.

Posterior Cerebral Artery (PCA) Stroke

• Causes visual problems, including cortical blindness and homonymous hemianopsia.
• Can result in memory issues, and if left-sided, can cause reading, writing, and naming problems.
• Causes Coordination deficits.

Right Sided Strokes

• Can result in Wallenberg's Syndrome.
• Can result in impaired vision following a PCA stroke.
• Can result in Neglect and impulsivity following a MCA stroke.

Central Cord Syndrome

• Often results from cervical hyperextension injuries, especially in the elderly with spinal stenosis.
• Neck injuries are a common cause.
• Trunks and legs are typically less affected.
• Results in bladder dysfunction.
• The arms are more affected than the legs.
• Causes loss of pain and temperature sensation below the injury level.

Brown-Sequard Syndrome

• Typically caused by a bullet or stabbing injury.
• Results in paralysis and proprioception loss on the same side as the injury.
• Causes loss of pain and temperature sensation on the opposite side of the injury.
• Walking is still possible, but affected.
• Neurological deficits are asymmetric.

Anterior Cord Syndrome

• Commonly caused by an anterior spinal artery infarct.
• Results in paralysis due to corticospinal tract damage.
• Causes loss of temperature and pain sensation due to spinothalamic tract damage.
• Preserves touch, vibration, and proprioception because the dorsal columns remain intact.

Posterior Cord Syndrome

• Causes Proprioception loss.
• Occurs due to trauma, MS, or tumors.
• Causes bilateral sensory deficits, affecting discriminative touch and vibration.
• Tactile discrimination is impaired.

Posterolateral Cord Syndrome

• Causes bilateral loss of proprioception, vibration, and touch.
• Results in lateral spastic paralysis.
• Leads to coordination problems, such as ataxia.
• Associated with severe demyelination disorders like B12 deficiency, MS, and AIDS.

Anterior Horn Cell Syndrome

• Affects alpha motor neurons through anterior horn destruction.
• Causes hypotonia (flaccid paralysis).
• Can be caused by poliomyelitis and ischemia.
• Symptoms include bilateral flaccidity.

Conus Medullaris Syndrome

• Causes bowel and bladder issues.
• More symmetric than Cauda Equina Syndrome.
• Onset can be sudden.
• Causes areflexic bladder/bowel.
• Results in unusual sensory loss.
• Typically due to spinal injury at L1/L2.

Concise study notes on stroke and spinal cord syndromes, including MCA, ACA, and vertebrobasilar strokes. Also covers Wallenberg’s Syndrome, detailing symptoms, motor deficits, communication issues, attention deficits, and visual impairments.