clinical neuroanatomy I
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- lesion of Spinocerebellar tracts
- upper limb ataxias (usually masked by complete paralysis of brown sequard
- common cause of subarachnoid bleed
- arterial aneurysm
- ALS lesions from cord to cortex
- contralateral loss of pain and temperature at or below the level of the lesion
- Large lesion of the dorsolateral medulla
- causes a constellation of effects which includes both the spinal trigeminal tract and the nerby ALS. this produces a characteristic alternating hemianalgesia-hemithermoanestheisa = loss of pain an dtemp from the face is ipsilateral while loss of of pain and temp from the trunk and limbs is contralateral
- hydromyelia
- abnormal enlargement of the central canal. pressure can result in both motor and sensory loss
- CT scan of non communicating hydrocephalus
- no 4th venticle enlargement
- CT scan of communicating hydrocephalus
- enlarged 4th ventricle and subarachnoid space
- Obstruction of at or beyond teh cerebral aqueduct is evidenced by
- expansion of the lateral ventricles, interventricular formen and third venticles
- lesion of the spinal trigeminal tract-nucleus
- results in a characteristic ipsilateral loss ofpain and temp senses from teh head and face without loss of touch.
- a PT presented to a docotr complaining of H/A, nauses difficulty controlling eye momements and double vision. the paiteint was referred to a neurologist who suspected a single tumor causing both types of symptoms resulting from compression of both ventricular and visual structures. A midsagittal MRI was ordered. Where in the CNS can both a ventricular structure and eye reflex pahtways be compressed simultaneously? what kind of tumor might this be? why was a midsagittal view ordered?
- a pineal tumor may compress the eye reflex nuclei (leading to double vision) and teh cebreal aqueduct (leading to consequences from hyrodrocephalus
- tabes dorsalis
- slowly pregressive degenerative disease secondary to spirchete infection which involves demyelination of POSTERIOR COLUMS AND ROOTS with neruologic presentation o foss of discriminative touch and conscious proprioception bilaterally
- Absence and lesions of the corpus callosum
- dissconection syndroms (split brain)
- lesion of dorsal column
- ipisalteral loss of descriminative touch and conscious proprioception below the level of the lesion
- lesion of broca's area
- (BA 44/45=speech) causes aphasia
- lesion of the medial lemniscus, VPL thalamus, PLIC, or upper and medial soatosensory cortex
- ccomplete contralateral loss of descriminative touch and conscious proprioception
- lesion of the postcentral gyrus
- (BA 3,1,2) sensory cortex) causes anestheisa of the corresponding part
- a callostomy is used to treat what
- intractable eplieptic seizures
- anterior spinal arterial infartion at T9
- loss of pain and temp sense below T9
- what surgical procedure produces split brain or disconnection syndromes
- sectioning the callosum (callostomy)
- what parts of teh frontal lobe must be spared if a person has damage but remains without injury other than personality change?
- Broca's area and frontal eye fields
- where can subarachnoid beeds spread that subdural bleeds cant
- into the depths of the sulci
- S/E of callostomy
- inability to say what is seen in the left visual field because the visual info goes to the right brain but the verbal control center is on teh left side.
- Brown Sequard syndrom
- unilateral lsesion of half the spinal cord. descriminative touch an dconscoius proprioception are lost ipsilateally from the lesion level down
- What is physically seen in alzheimers pts
- reduction in gray matter wit enlarged sulci
- syringomyelia
- spinal cord diseases involving a fluid filled cavity in the cord. an example is hydromyelia
- non commuicating obstructive hydrocphalus
- blockage of part of the ventricular system (aqueductal stenousus) preventing CSF flow out of the brain into the subarachnoid space
- Communicating hydrocephelus
- failure of absorption at the granulations or blockage of the subrachnoid spaces along with unobstructed flow throught the ventricles
- MS
- often results in locus of dorsal column
- Lesion of the precentral gyrus
- (BA4=motor cortex) causes paralysis of the corresponding part
- sensory features of brown sequrd syndrome
- (equal to spinal cord hemisection ) ipsilateral loss of touch an dconscious proprioception, contralaeral loss of pain and termperature sense. loss of ipsilateral 2nd order pain and temp neurons at teh lesion level is clinically unimportant
- Expansion of the lateral ventricles resulting from obstruction at or beyond the cerebral aqueduct cause
- stretching of the corpus callosum and compression of the cerebral cortex. the normal genu an dsplenium dissapear an dthe septum pellucidum is very big
- lesion of wernicke's
- (BA22 language) inability to understand written or spoken speech
- A man suffereing from a iron bar projected through his left cheek bone into his skull and exiting the top after passing throught the left frontal cortex. Suffered only from personality change such that he was opposite to his original character in many ways. What brain functions are associated with the frontal cortex?
- higher functions such as thinking, cognition personality
- how can a subarachnoid bleed spread
- accumulate in the confines of the dura and cannont pass across a falx.
- jaw jerk reflex
- tests the integrity of th emandibular and trigeminal nerves as well as teh central nuclei and paths involved
- trigeminal neuralgia
- excruciating hyperalgesia from the face
- Cingulotomy has replaced what former surgery and is uesed to treat
- frontal lobotomy, psychosurgery, OCD, cancer patients
- lesion of the posterior commissure
- affect vertical gaze (looking up)
- post lesion of corpus callosum
- visula info from the right occiput (left visual field) doesnt reach teh left side so teh left side motor speech area cant sy what is being seen
- what are is a mickey mouse appearance in horizontal sections indicative of
- enlargemnt of the anterior horns resulting from obstruction of or at cerebral aqueduct
- What condition did Kim Peek and the "rainman" have
- callosal agenesis (congenital absence of the corpus callosum and anterior commisure
- specific (focal) lesion of the superior longitudinal fasiculus what problems and why?
- problems of speeh and language because it connects wernicke's area with broca's area
- unilateral enlargement of a lateral ventricle suggests
- unitlateral obstruction of th eipsilateral interventricular foramen