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Medicine (MD/DO)
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USMLE Step 2
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Neurology, Ophthalmology & Otology
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Ischemic Brain Disease (Stroke)

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Neurology, Ophthalmology & Otology | Medicine (MD/DO) School Study Aid

Ischemic Brain Disease (Stroke)
10 Picmonics to Learn | 21 mins
Types of Strokes
Warning Signs
Transient Ischemic Attack (TIA)
Reversible Ischemic Neurologic Deficit (RIND)
Types
Ischemic
Thrombotic
Atherosclerosis
Embolic
Atrial Fibrillation
Hemorrhagic
Severe Hypertension
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3 mins
Middle Cerebral Artery
Contralateral paralysis upper limb and face
Contralateral loss of sensation of upper limb and face
Affects Wernicke's area and Broca's area
Aphasia if Lesion in Dominant (Left) Hemisphere
Hemineglect if lesion in nondominant (right) hemisphere
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1 min
Left Hemisphere Stroke Assessment
Opposite Side Weakness (Hemiplegia)
Side to Side Discrimination
Aphasia
Agraphia
Slow Performance
Aware of Deficits
Anxiety
Depression
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2 mins
Right Hemisphere Stroke Assessment
Opposite Side Weakness (Hemiplegia)
Poor Proprioception
Disoriented to Person, Place, Time
Can't Recognize Faces (Prosopagnosia)
Loss of Judgement and Awareness
Impulsiveness
Personality Changes
Tonal Hearing Loss
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2 mins
Anterior Cerebral Artery
Contralateral paralysis of lower limb
Contralateral loss of sensation in lower limb
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1 min
Basilar Artery Stroke Assessment
Characteristics
Brainstem Structures
Lateral Corticospinal and Corticobulbar Tracts
Clinical Findings
Locked-in Syndrome
Motor Dysfunction
Preserved Vertical Eye Movements
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2 mins
Anterior Inferior Cerebellar Artery Stroke Assessment
Characteristics
Anterior Inferior Cerebellar Artery
Lateral Pontine Syndrome
Ipsilateral Clinical Findings
Decreased Facial Pain and Temperature Sensation
Facial Muscle Weakness
Decreased Taste from Anterior 2/3 of Tongue
Deceased Salivation and Lacrimation
Nystagmus and Hearing Loss
Horner Syndrome
Ataxia
Contralateral Clinical Findings
Decreased Body Pain and Temperature Sensation
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3 mins
Histologic Evolution of Ischemic Stroke
> 5 Minutes
Irreversible Neuronal Injury
12-24 hours
Red Neurons
1-3 days
Liquefactive Necrosis (Neutrophils)
3–5 Days
Microglia
1-2 Weeks
Reactive Gliosis (Astrocytes)
Vascular Proliferation
> 2 weeks
Glial Scar
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2 mins
Gerstmann Syndrome
MCA Stroke
Angular Gyrus
Parietal Lobe
Dominant Hemisphere
Integration of Visual, Acoustic, and Sensory Information
Components of Gerstmann Syndrome
Left-Right Disorientation
Finger Agnosia
Agraphia
Acalculia
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2 mins
Wallenberg Syndrome (PICA Syndrome)
PATHOPHYSIOLOGY
Compromise of PICA
Lateral Medullary Ischemia
CLINICAL FEATURES
Vertigo
Nystagmus
Nausea and Vomiting
Loss of Pain and Temperature in the Ipsilateral Face
Loss of Pain and Temperature Sensation in the Contralateral Limbs
Dysphagia
Dysarthria and Dysphonia
Loss of Gag Reflex
Ipsilateral Horner Syndrome
Ipsilateral Ataxia and Dysmetria, as well as Dysdiadochokinesia
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4 mins

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