Card Set Information
Neuroanatomical Localisation CNS lesions
Info for VIVA
General issues of lesions
- site of lesion
- size/ extent of lesion
- pathological process
- potentialfor treatment/ recovery
- age/ neuroplasticity
- stage of rehabilitation
: primary problems vs secondary changes
How do you know if a lesion is an upper motor neuron syndrome?
-weakness or paralysis of movement
- no profound wasting- global
- spasticity and hyperreflexia
- primitive reflexes
How do you know if a lesion is an lower motor neuron syndrome?
- weakness or paralysis of individual muscles
- wasting- specific mm wasting
- fasciculation- spontaneous firing of nerves
- hypotonnia and hyporelexia/areflexia
What symptoms would a patient have if they have a cerebellar lesion?
- poor postural control
- nystagmus (voluntary or involuntary eye movement)
- intention tremour- tremour when you move
- dysmetria- inaccuracy with reach
- rebound phenomenon (oppose elbow flex when you remove force and the pt will continue to contract)
- dysdiadokineasia- cant rapidly alt movements
- dysynergia- inability turn mm off/on
How can you tell if a pt has a basal ganglia lesion?
- motor control (bradykineasia)
- mm tone (eg rigidity)
- involuntary movements (eg resting tremour, chorea (big movement), athetosis (small), hemiballisums (violent/ abrubt)
- NO weakness or sensory loss
How can you tell if a pt has a thalamic lesion?
- pain direct consequence- only this type
- loss of sensation in the contralateral face and limbs
- thalamic pain/ causalgia (burning pain)
- emotional disturbance- hypothalamus
- sleep/ wake cycle problems
: can mimic cortical defects
What are some mid brain syndromes that may occur as a result of brainstem lesion?
- medial pons syndrome
- wallenberg syndrome- most common- lesion in pons
- locked syndrome- upper pons/ medualla- paraplegia and face movements
- unilateral lesion
: ipsilesional CN findings, contralateral motor and sensory signs
- bilateral lesions = coma and death
what are the types of lesions?
- vascular (occlusive, haemorrhagic)
- traumatic (focal, diffuse) - car accident
- trauma (benign, malignant)
- infective (bacterial, viral)
- congenital/ developmental
- other eg demyelinating disease
Where does the ACA feed?
- anterior circulation feeds the optic nerves, frontal, parietal and temporal lobes
where does the posterior circulation feed?
- cerebellum, brainstem, thalamus, occipital lobe and the medial part of the temporal bone
intracranical haemorrhage types?
- extradural haematoma- trauma- blood outside between dura and skull- #s and skull fracture
- subdural haematoma- can be acute or chronic- blood under dura, caused by rupture of veins in subdural space
Above 2 not stroke- out side of brain
- intracerebral haematoma- trauma, AVM, tumour, HT
- subarachnoid haemorrhage- trauma, aneurysm- blood below the arachnoid in the subarachnoid space, due bleeding of vessles on surface of the brain mixes with CSF
What are the different types of traumatic lesions?
- penertrating force
: foreign object, skull #, gun shot
- acceleration/ deceleration
: contusions and bleeds
: sheering/tearing of axons and blood vessels- grey and white matter moves at different speeds
- secondary injury
: hypoxia, metabolic effets, infection, system failure