Stroke Syndromes

Vignette#1:A77-year-old woman was cooking in the kitchen when she collapsed onto the floor.Her daughter called an ambulance and the woman was taken to the emergency room.She had suffered a stroke, and slowly regained consciousness over the next twodays. However, when she woke up, she had the following signs and symptoms:– paralysis of the right face andarm– loss of sensation to touch on theskin of the right face and arm– inability to answer questions butability to understand what was said to her – ability to write down her thoughtsmore easily than to speak themQuestions:1. Based upon the patient’ssymptoms, which cerebral artery was blocked? (Be Specific)
2. Why was she paralyzed in theright face and arm?
3. What is the name of her languagedisorder, and what caused it?
4. Was this woman’s dominant ornondominant hemisphere damaged?
Vignette#2:A61-year-old business executive with a long history of high blood pressurecollapsed while jogging over the lunch hour. His jogging mate quickly contacteda police officer who helped carry the man to a hospital just down the road. Atthe hospital, an MRI was performed that revealed a blockage of a major cerebralartery and ischemic changes to the portion of the brain supplied by thatartery. With quick medical attention, the man was stabilized, and he slowlyimproved over the next three weeks. The following signs and symptoms didpersist, however:– paralysis of the right leg andfoot– loss of sensation on the skin ofthe right leg and foot– when blindfolded, inability toidentify a tennis ball placed in the left hand, but ability to name it ifplaced in the right hand– inability to throw the tennisball with his left hand, but ability to throw it with his right hand
Questions:1. Which artery was blocked in thiscase? (Be Specific)
2. Explain why he is unable toidentify the tennis ball when it is placed in his left hand. In yourexplanation, be sure to discuss all of the relevant pathways down which nerveimpulses must pass in order to name the object.
3. Explain why he is unable tofollow the verbal command to throw the tennis ball with his left hand but cando so when asked to with his right hand. In your explanation, be sure todiscuss all of the relevant pathways down which nerve impulses must pass inorder follow these commands.
4. Why has he lost sensation in theright leg and foot?
Vignette#3:An81-year-old man and avid reader had a mild stroke from which he eventuallyrecovered. He did have some residual signs and symptoms, however, such as:·right-sidedhomonymous hemianopia (i.e. loss of vision on the right half of the visualfield in each eye)·alexia(“dyslexia”), the inability to read, which greatly frustrated thisman – loss of sensation on the skin on the right side of the bodyQuestions:1. What cerebral artery was blockedduring his stroke? (Be Specific.)
2. Why was this man unable to seethe right half of his field of vision? Was there something wrong with his eyes?
3. If this man could still see theleft half of his visual field, why did he still have difficulty reading? Inyour answer, be sure to mention all of the relevant pathways down which nerveimpulses must travel for him to be able to read.