SCRN EXAM REVIEW EXAM 2026/2027 UPDATED.
Posterior Cerebral Artery (PCA) - ANSWER Arises from basilar.
Supplies Occipital Lobe , Midbrain, Thalamus, Pineal Gland, Choroid
Plexus, and Corpus Callosum
Symptoms of PCA Stroke - ANSWER -Contralateral Visual Field
Homonymous hemianopia
-Visual Agnosia (unable to interpret/recognize visual information)
- Weber's Syndrome (3rd nerve palsy + contralateral hemiplegia)
-Parinaud's Syndrome (Impaired upwards gaze,
convergence-retraction nystagmus, primary conjugate downward
gaze)
Anterior Inferior Cerebellar Artery (AICA) - ANSWER Feeds
anterior inferior parts of the cerebellum
Symptoms of AICA Stroke - ANSWER Lateral Pontine Syndrome:
vertigo, vomiting, nystagmus, falling towards the side of the lesion,
ipsilateral loss of sensation to the face, ipsilateral facial paralysis,
ipsilateral hearing loss
Posterior Inferior Cerebellar Artery (PICA) - ANSWER Feeds
cerebellum, superior section of the medulla,. Choroid plexus and
fourth ventricle
Symptoms of PICA Stroke - ANSWER Wallenburg Syndrome
(lateral Medullary Syndrome): Loss of pain and temperature
sensation in the contralateral trunk and ipsilateral face
Basilar Artery - ANSWER An artery, formed by the fusion of the
vertebral arteries, that supplies blood to the brainstem (medulla and
pons) and to the posterior cerebral arteries.
Symptoms of Basilar Artery Stoke - ANSWER Coma,
quadriparesis, ataxia, dysarthria, CN dysfunction and visual deficits,
,Locked in Syndrome, Intranuclear Opthalmoplegia, gaze paresis,
Millard Gulber Syndrome CN VI VII damage (diplopia facial
weakness, loss of corneal reflex), Nausea, vomiting, diplopia, gaze
palsy, dysarthria,. vertigo, tinnitus, hemiparesis, and quadriplegia.
Anterior Cerebral Artery (ACA) - ANSWER Feeds the media
portion of the frontal and parietal lobes as well as the corpus
callosum
Symptoms of ACA Stroke - ANSWER Contralateral motor/sensory
deficits impacting legs > arms
Middle Cerebral Artery (MCA) - ANSWER Feeds majority of the
frontal, parietal, and temporal lobes, basal ganglia, internal capsule.
It is divided M1 - M4
Symptoms of MCA Stroke - ANSWER -Aphasia if dominant
hemisphere
-Neglect if non-dominant hemisphere
-Contralateral motor/sensory loss of face/arm/leg with Arms > Legs
-Anosognosia: neglect or lack of self awareness
Venous Vascular Anatomy - ANSWER Venous channels enter into
venous sinuses located in the Dura matter.
Superior Sagittal Sinus - ANSWER Travels posteriorly between the
cerebral hemispheres towards the occiput
Straight Sinus - ANSWER Travels along the tentorium, draining
blood from the superior cerebellar veins.
Transverse Sinus - ANSWER Travels along the base of the occiput
laterally and forwardly
Sigmoid Sinus - ANSWER Begins beneath the temporal bone and
travels to the jugular foramen where it becomes the internal jugular
veins
,Stroke Pathophysiology - ANSWER Arterial blood flow to the brain
tissue fails to meet metabolic demands resulting in cell damage or
death. ISCHEMIA FIRST THEN INFARCT.
Penumbra - ANSWER Zone surrounding the core infarct, damaged
by ischemia but not yet infarcted
---- functionally silent yet metabolically active
Hypoxia leading to Necrotic Pathway - ANSWER Cell energy
failure
Hypoxia leading to Apoptotic Pathway - ANSWER Programmed
cell death in the penumbral zone
ICH Stroke Pathophysiology - ANSWER Occurs when a cerebral
blood vessel opens abnormally and spills blood into brain tissue.
Classification of ICH Brain Injury - ANSWER Primary Brain Injury:
Direct result of the hematoma
Secondary Brain Injury: Hours or days after ICH, mass effect causes
mechanical disruption and damage to cell membranes
SAH Stroke Pathophysiology - ANSWER Aneurysm from s in the
cerebral vasculature and ruptures, resulting in blood spilling in the
subarachnoid space
Saccular Aneurysm - ANSWER narrow neck, widened dome --
Most Common
Fusiform Aneurysm - ANSWER Outpouching of the vessel without
a distinct neck --- Less common
Early Brain Injury - ANSWER Hours and first several days after
aneurysm rupture cerebral edema forms, injury results from
decreased cerebral blood flow
Cerebral Vasospasm (Delayed Cerebral Injury) - ANSWER Large
Vessel Spasm generally begins on day 4 continues up to 21 days
, Brain Requirements - ANSWER 20% of the body's Oxygen
15% of the body's Cardiac Output
Cerebral Blood Flow - ANSWER Normal: 50 - 55 mL/100g/min
Oligemia: 30 - 40 mL/100g/min
Moderate Ischemia (the penumbra): 20 - 30 mL/100 g/min
Severe ischemia and Cell Death: 0 - 10 mL/100 g/min
Large Vessel occlusion - ANSWER Embolic: develop elsewhere
and travel to blood vessel in the brain
Small Vessel Occlusion - ANSWER Thrombotic: caused by a clot
that develops in the vessel of the brain
Cerebral Cortex - ANSWER Grey matter on the outermost section
of the cerebrum and cerebellum
Divided into four lobes
- Frontal
- Parietal
- Occipital
- Temporal
Frontal Lobe - ANSWER motor, behavioral expression.
Motor/sensory maps
Parietal Lobe - ANSWER Sensation, optic radiations carrying
sensory input from the eyes, language centers *typically left side of
brain*
Language Centers - ANSWER Broca's: Production/Expressive
Wernicke's: Comprehension/Receptive
Posterior Cerebral Artery (PCA) - ANSWER Arises from basilar.
Supplies Occipital Lobe , Midbrain, Thalamus, Pineal Gland, Choroid
Plexus, and Corpus Callosum
Symptoms of PCA Stroke - ANSWER -Contralateral Visual Field
Homonymous hemianopia
-Visual Agnosia (unable to interpret/recognize visual information)
- Weber's Syndrome (3rd nerve palsy + contralateral hemiplegia)
-Parinaud's Syndrome (Impaired upwards gaze,
convergence-retraction nystagmus, primary conjugate downward
gaze)
Anterior Inferior Cerebellar Artery (AICA) - ANSWER Feeds
anterior inferior parts of the cerebellum
Symptoms of AICA Stroke - ANSWER Lateral Pontine Syndrome:
vertigo, vomiting, nystagmus, falling towards the side of the lesion,
ipsilateral loss of sensation to the face, ipsilateral facial paralysis,
ipsilateral hearing loss
Posterior Inferior Cerebellar Artery (PICA) - ANSWER Feeds
cerebellum, superior section of the medulla,. Choroid plexus and
fourth ventricle
Symptoms of PICA Stroke - ANSWER Wallenburg Syndrome
(lateral Medullary Syndrome): Loss of pain and temperature
sensation in the contralateral trunk and ipsilateral face
Basilar Artery - ANSWER An artery, formed by the fusion of the
vertebral arteries, that supplies blood to the brainstem (medulla and
pons) and to the posterior cerebral arteries.
Symptoms of Basilar Artery Stoke - ANSWER Coma,
quadriparesis, ataxia, dysarthria, CN dysfunction and visual deficits,
,Locked in Syndrome, Intranuclear Opthalmoplegia, gaze paresis,
Millard Gulber Syndrome CN VI VII damage (diplopia facial
weakness, loss of corneal reflex), Nausea, vomiting, diplopia, gaze
palsy, dysarthria,. vertigo, tinnitus, hemiparesis, and quadriplegia.
Anterior Cerebral Artery (ACA) - ANSWER Feeds the media
portion of the frontal and parietal lobes as well as the corpus
callosum
Symptoms of ACA Stroke - ANSWER Contralateral motor/sensory
deficits impacting legs > arms
Middle Cerebral Artery (MCA) - ANSWER Feeds majority of the
frontal, parietal, and temporal lobes, basal ganglia, internal capsule.
It is divided M1 - M4
Symptoms of MCA Stroke - ANSWER -Aphasia if dominant
hemisphere
-Neglect if non-dominant hemisphere
-Contralateral motor/sensory loss of face/arm/leg with Arms > Legs
-Anosognosia: neglect or lack of self awareness
Venous Vascular Anatomy - ANSWER Venous channels enter into
venous sinuses located in the Dura matter.
Superior Sagittal Sinus - ANSWER Travels posteriorly between the
cerebral hemispheres towards the occiput
Straight Sinus - ANSWER Travels along the tentorium, draining
blood from the superior cerebellar veins.
Transverse Sinus - ANSWER Travels along the base of the occiput
laterally and forwardly
Sigmoid Sinus - ANSWER Begins beneath the temporal bone and
travels to the jugular foramen where it becomes the internal jugular
veins
,Stroke Pathophysiology - ANSWER Arterial blood flow to the brain
tissue fails to meet metabolic demands resulting in cell damage or
death. ISCHEMIA FIRST THEN INFARCT.
Penumbra - ANSWER Zone surrounding the core infarct, damaged
by ischemia but not yet infarcted
---- functionally silent yet metabolically active
Hypoxia leading to Necrotic Pathway - ANSWER Cell energy
failure
Hypoxia leading to Apoptotic Pathway - ANSWER Programmed
cell death in the penumbral zone
ICH Stroke Pathophysiology - ANSWER Occurs when a cerebral
blood vessel opens abnormally and spills blood into brain tissue.
Classification of ICH Brain Injury - ANSWER Primary Brain Injury:
Direct result of the hematoma
Secondary Brain Injury: Hours or days after ICH, mass effect causes
mechanical disruption and damage to cell membranes
SAH Stroke Pathophysiology - ANSWER Aneurysm from s in the
cerebral vasculature and ruptures, resulting in blood spilling in the
subarachnoid space
Saccular Aneurysm - ANSWER narrow neck, widened dome --
Most Common
Fusiform Aneurysm - ANSWER Outpouching of the vessel without
a distinct neck --- Less common
Early Brain Injury - ANSWER Hours and first several days after
aneurysm rupture cerebral edema forms, injury results from
decreased cerebral blood flow
Cerebral Vasospasm (Delayed Cerebral Injury) - ANSWER Large
Vessel Spasm generally begins on day 4 continues up to 21 days
, Brain Requirements - ANSWER 20% of the body's Oxygen
15% of the body's Cardiac Output
Cerebral Blood Flow - ANSWER Normal: 50 - 55 mL/100g/min
Oligemia: 30 - 40 mL/100g/min
Moderate Ischemia (the penumbra): 20 - 30 mL/100 g/min
Severe ischemia and Cell Death: 0 - 10 mL/100 g/min
Large Vessel occlusion - ANSWER Embolic: develop elsewhere
and travel to blood vessel in the brain
Small Vessel Occlusion - ANSWER Thrombotic: caused by a clot
that develops in the vessel of the brain
Cerebral Cortex - ANSWER Grey matter on the outermost section
of the cerebrum and cerebellum
Divided into four lobes
- Frontal
- Parietal
- Occipital
- Temporal
Frontal Lobe - ANSWER motor, behavioral expression.
Motor/sensory maps
Parietal Lobe - ANSWER Sensation, optic radiations carrying
sensory input from the eyes, language centers *typically left side of
brain*
Language Centers - ANSWER Broca's: Production/Expressive
Wernicke's: Comprehension/Receptive
