Vertebrobasilar Artery Syndrome (VBA) Anatomy

20 Questions

What is the characteristic feature of a Transient Ischemic Attack?

Temporary interruption of blood supply

Which artery syndrome is associated with unilateral neglect and perceptual deficits?

Middle Cerebral Artery (MCA) Syndrome

What is the term for the inability to perform previously learned motor skills due to brain damage?

Apraxia

Which symptom is commonly seen in patients with Lacunar Stroke?

Hemiparesis

What is the term for the loss of motor coordination and balance?

Ataxia

Which artery syndrome is associated with cranial nerve abnormalities?

Vertebrobasilar Artery Syndrome

What is the primary structure affected in Broca's Aphasia?

Third frontal convolution (Broca's Area)

What is the primary cognitive impairment in Wernicke's Aphasia?

Impaired auditory comprehension

What is the outcome if the Internal Carotid Artery (ICA) is occluded?

Coma and death

Which artery supplies the occipital lobe, medial temporal lobe, and inferior temporal lobe?

Posterior Cerebral Artery (PCA)

What is the term for a stroke that affects the brainstem, cerebellum, and thalamus?

Vertebrobasilar Artery Syndrome

What type of aphasia is characterized by non-fluent speech with poor comprehension?

Global Aphasia

What is the primary symptom of a vertebral artery syndrome?

Loss of consciousness

Which structure is NOT supplied by the basilar artery?

Cerebrum

What is the primary symptom of a lacunar stroke affecting the posterior limb of the internal capsule?

Contralateral hemiplegia

What is the characteristic of a locked-in syndrome?

Preserved consciousness and sensation

Which cranial nerve abnormality is associated with vertebral artery syndrome?

All of the above

What is the primary symptom of a lacunar stroke affecting the ventrolateral thalamus?

Contralateral hemisensory loss

What is the characteristic of a lacunar stroke affecting the junction of the internal capsule and thalamus?

Contralateral sensory and motor loss

What is the characteristic of a vertebral artery syndrome?

All of the above

Study Notes

Vertebral Basilar Artery Syndrome (VBA)

Vertebral artery supplies the cerebellum and medulla
Basilar artery supplies the pons, cerebellum, and internal ear
Symptoms:
- Loss of consciousness/coma
- Cerebellar abnormalities:
  - Ataxia of limbs and gait
  - Nystagmus
- Cranial nerve abnormalities affecting pons and medulla
- Tract abnormalities:
  - Mutism
  - Facemute pain
  - Impaired CST, CBT, and spinothalamic tract
  - Paralysis of face, UE, and LE
  - Impaired pain and thermal sense

Classification

Vertebral Basilar Artery Syndrome (VBA)

Horner's Syndrome:
- Miosis
- Ptosis
- Decreased sweating
Locked-In syndrome:
- Complete basilar artery occlusion
- Sudden onset
- Tetraplegia
- Bilateral cranial nerve palsy
- Preserved consciousness and sensation
- Impaired horizontal eye movements
- Vertical eye movements and blinking intact

Lacunar Stroke

Result from occlusion of small perforating vessels deep in the brain
Mostly asymptomatic
Types:
- Pure Motor Stroke:
  - Affects posterior limb of the internal capsule, pons, and pyramids
  - Contralateral hemiplegia
- Pure Sensory Stroke:
  - Affects ventrolateral thalamus and thalamocortical projections
  - Contralateral hemisensory loss and thalamic pain syndrome
- Sensory Motor Stroke:
  - Affects junction of internal capsule and thalamus
  - Contralateral sensory and motor loss

Middle Cerebral Artery Syndrome (MCA)

Aphasia:
- Broca's Aphasia:
  - Motor speech impairment
  - Non-fluent
  - Slow, hesitant speech
  - Structure affected: Third frontal convolution (Broca's Area)
- Wernicke's Aphasia:
  - Receptive speech impairment
  - Fluent speech with normal rate
  - Impaired auditory comprehension
  - Structure affected: Posterior portion of temporal gyrus (Wernicke's Area)
- Global Aphasia:
  - Non-fluent speech with poor comprehension

Internal Carotid Artery Syndrome (ICA)

ICA supplies: ACA and MCA
If occluded, will affect structures supplied by MCA
Symptoms:
- Seizures
- Hemiparesis
- Hemisensory loss
- Hemianopsia
- Coma
- Death

Posterior Cerebral Artery Syndrome (PCA)

PCA supplies:
- Occipital lobe
- Medial and inferior temporal lobe
- Upper brainstem
- Midbrain
- Diencephalon
- Thalamus

Hemorrhagic Stroke

No specific symptoms mentioned

Management Categories

Transient Ischemic Attack:
- Temporary interruption of blood supply
- Symptoms last for ≤ 24 hours
- UE affectation based on homunculus
Apraxia: ideational/ideomotor
Abulia: slow mutation

Anterior Cerebral Artery Stroke (ACA)

No specific symptoms mentioned

Middle Cerebral Artery Syndrome (MCA)

MCA supplies:
- Lateral frontal lobe
- Parietal lobe
- Temporal lobe
- Basal ganglia
- Internal capsule
Symptoms:
- UE > LE affectation
- L hemisphere affectation: Aphasia (Broca's, Wernicke's, and Global)
- R hemisphere affectation: Perceptual deficits (unilateral neglect, depth perception, spatial relations, and agnosia)
- Vision problems (homonymous hemianopsia)

This quiz covers the anatomy and symptoms of Vertebrobasilar Artery Syndrome (VBA), including the supplies of vertebral and basilar arteries, and its effects on the brain and nervous system.

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