module1part2
DESCRIPTION
abcdTRANSCRIPT
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Clinical Application
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Case History
• 57 year-old right-handed man presents with neck pain and the sudden onset of neurologic deficits.
• Key findings
– 1. Inability to speak but understands
– 2. Weakness of the right face, arm and leg
– 3. Numbness of the right face, arm, and leg
– 4. Inability to see the right side of the world
– 5. Deviation of the eyes to the left
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1. Inabi l i ty to speak but understands
• Aphasia
– Loss of ability to produce or understand
language
• An asymmetric function of the brain
Medina LS, Radiology 2007
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Neuroanatomy of Aphasia
1. Broca’s area:
Inability to
speak
2. Wernicke’s
area: Inabilty
to comprehend
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MRI Brain
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MRI Brain
1. Broca’s aphasia:
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2. Weakness o f the r igh t face, arm and leg
• Weakness can result from injury to the…
– Brain
– Spinal Cord
– Peripheral Nerves or their cell bodies
– Neuromuscular Junctions
– Muscles
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Upper and Lower Motor Neurons
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Central Sulcus
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The Homunculus
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From the London Natural History Museum
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The Corticospinal Tract
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MRI Brain
1. Broca’s aphasia:
2. Weakness
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3. Numbness o f the r igh t face, arm, and leg
• Two parallel systems mediating sensation
from the body
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Posterior/Dorsal Column Pathway
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Spinothalamic Pathway
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The Homunculus
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Spinothalamic Pathway
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MRI Brain
1. Broca’s aphasia:
2. Weakness
3. Numbness
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4. Inab i l i t y to see the r igh t s ide o f the wor ld
http://en.wikipedia.org/wiki/Visual_field
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Major Functions of the Cortex
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The Visual Pathways
Left Right
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MRI Brain
1. Broca’s aphasia:
2. Weakness
3. Numbness
4. Visual loss
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5. Deviation of the eyes to the left
• Each hemisphere is involved in moving the
eyes in the direction away from that
hemisphere
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Left Gaze Deviation
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5. Deviat ion of the eyes to the left
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MRI Brain
1. Broca’s aphasia:
2. Weakness
3. Numbness
4. Visual loss
5. Gaze Deviation
![Page 28: Module1Part2](https://reader034.vdocuments.site/reader034/viewer/2022051418/563db925550346aa9a9a753f/html5/thumbnails/28.jpg)
MRI Brain
1. Broca’s aphasia:
2. Weakness
3. Numbness
4. Visual loss
5. Gaze Deviation
![Page 29: Module1Part2](https://reader034.vdocuments.site/reader034/viewer/2022051418/563db925550346aa9a9a753f/html5/thumbnails/29.jpg)
MRI Brain
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MRI Brain
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Vascular Supply to the Brain
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Circle of Will is
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Territory of Major Vessels
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CT Angiography Brain
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Where Do Cerebra l Embol i Come From?
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CT Angiography Neck
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CT Angiography Neck