The neurosurgical implications of PICA strokes

If your big PICA stroke gets worse, there are plenty of possible causes – here is a list:

  1. Direct brainstem compression
    – typically affects the contralateral corticospinal tract, often above it’s crossin, so that an ipsilateral hemiparesis occurs
    – pontomedullary motor cranial nerves might be affected
    – vertigo, oculomotor abnormalities
  2. Hydrocephalus from
    – Compression of the IIIrd ventricle
    – Compression of the aqueduct
    – Compression of the IVth ventricle
  3. Ascending transtentorial herniation
    – Somnolence
    – Vertical oculomotor abnormalities
    – Vertigo
  4. Transforaminal herniation
    – Vertigo
    – Nystagmus
    – Medullary brainstem signs
Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s