The middle cerebral artery is the largest branch of the internal carotid artery and supllies the largest area of the cerebral cortex
Supplying the motor and sensory cortices, also supplies the areas of the cortex pertaining to the comprehension Wernicke’s area and expresion brocca’s area (left hemisphere)
localization of stroke, CVS, stroke, for post graduates Kurian Joseph
New localization of stroke syndromes
1.Clinical localization of the site of the lesion.
2.Identifying the vascular territory and the vessel involved.
3.Correlating with the imaging findings.
I. The carotid system.
II. The vertebral system.
1) The ophthalmic artery.
2) The anterior choroidal artery.
3) The posterior communicating artery
II. The Vertebro-Basilar System VOS
brain stem syndromes
localization of stroke, CVS, stroke, for post graduates Kurian Joseph
New localization of stroke syndromes
1.Clinical localization of the site of the lesion.
2.Identifying the vascular territory and the vessel involved.
3.Correlating with the imaging findings.
I. The carotid system.
II. The vertebral system.
1) The ophthalmic artery.
2) The anterior choroidal artery.
3) The posterior communicating artery
II. The Vertebro-Basilar System VOS
brain stem syndromes
A stroke is caused by the interruption of the blood supply to the brain, usually because a blood vessel bursts or is blocked by a clot. This cuts off the supply of oxygen and nutrients, causing damage to the brain tissue
Please find the power point on Brainsteam stroke. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
A stroke is caused by the interruption of the blood supply to the brain, usually because a blood vessel bursts or is blocked by a clot. This cuts off the supply of oxygen and nutrients, causing damage to the brain tissue
Please find the power point on Brainsteam stroke. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
The blood supply to the central nervous system (CNS), including the brain and spinal cord, is crucial for maintaining the metabolic needs of neural tissues.
Neurosurgical interventions related to the blood supply of the CNS are often aimed at addressing vascular abnormalities, preventing strokes, and managing conditions affecting blood vessels in the brain.
Cavernous Sinus Thrombosis.
Cerebrovascular Diseases - Strokes and Their Etiology with Cerebral Blood SupplySudheera Semasinghe
Cerebrovascular accidents/strokes and their etiology (cerebral blood supply) by O. D. Roshan Indika. REFERENCES :
HARRISON’S Principles of Internal Medicine
20th edition
Similar to Clinical syndromes of vascular disease of the nervous (20)
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
2. Middle cerebral artery occlusion
o The middle cerebral artery is the largest branch of the
internal carotid artery and supllies the largest area of the
cerebral cortex
o Supplying the motor and sensory cortices, also supplies
the areas of the cortex pertaining to the comprehension
Wernicke’s area and expresion brocca’s area (left
hemisphere)
3. Anterior cerebral artery
occlusion
o Occlusion proximal to the anterior communicating artery is normal well
tolerated because of adequate cross-flow and thus few symptoms result
o Occlusion distal to the anterior communicating artery causes contralateral
weakness and cortical sensory loss in the leg
o Incontinence is often present
o It is often involved secondary to occlusion more proximally in the internal
carotid
4. Posterior cerebral artery
occlusion
o The posterior cerebral arteries are the terminal branches
of the basiler artery
o In addition to cortical branches to the temporal lobe and
occipital and visual cortices, there are perforating
branches that supply the midbrain and thalamus
5. Posterior cerebral artery
occlusion
o Proximal occlusion : midbrain syndrome (weber’s syndrome) third nerve palsy
and contralateral hemiplegia, chorea or hemiballismus, hemisensory
disturbance
o Cortical vessel occlusion : homonymous hemianopia with macular sparing
o Bilateral occlusion : anton’s syndrome (cortical blindness)
6. Lacunar infarction
o A lacunar stroke occurs when one of the arteries that provide blood to the
brain's deep structures is blocked
o Approximately 25% of ischaemic strokes are due to infarction of the internal
capsule
o This originate from the origin of the middle cerebral artery and supply parts
of the internal capsule, basal ganglia and thalamus
7. Internal capsule stroke
o The internal capsule is one of the subcortical structures of the
brain
o Subcortical structures: internal capsule, caudate, putamen,
globus pallidus, thalamus, brainstem
o The anterior limb of the internal capsule separates the caudate
nucleus and lenticular nucleus
o The posterior limb separates the thalamus and lenticular nucleus
8. Types of fiber internal capsule
o Anterior limb: frontopontine fibers (frontal cortex to pons),
thalamocortical fibers (thalamus to frontal lobe)
o Genu (angle): corticobulbar fibers (cortex to brainstem)
o Posterior limb: corticospinal fibers (cortex to spine), thalamo
cortical fibers to parietal lobe (general sensory)
10. Blood supply of internal capsule
o Anterior limb: mainly fed by the lenticulostriate
branches of middle cerebral artery(MCA), less often
branches of anterior cerebral artery (ACA)
o Genu: lenticulostriate branches of MCA
o Posterior limb: lenticulostriate branches of MCA &
anterior choroidal artery (AChA) of internal carotid
artery
11. Symptoms and sign
Weakness of the face, arm, and/or leg (pure motor stroke) :
o Known as one of the classic types of lacunar infarcts, a pure motor stroke is the
result of an infarct in the internal capsule
o Upper motor neuron signs : hyperreflexia, Babinski sign, Hoffman present,
clonus, spasticity
Mixed sensorimotor stroke :
o Since both motor and sensory fibers are carried in the internal capsule, a stroke
to the posterior limb of the internal capsule (where motor fibers for the arm,
trunk and legs and sensory fibers are located) can lead to contralateral
weakness and contralateral sensory loss
12. Brainstem stroke
o Multiple patterns of deficit can arise depending on the exact location of the
lesion with respect to the long tracts
o Medial medullary syndrome : corticospinal tract, medial lemniscus (dorsum
column), hypoglossal nucleus (CN XII)
o Lateral medullary syndrome : vestibular nuclei (nystagmus, nausea, vomiting
and vertigo), inferior cerebellar peduncle (dystaxia, dysmetria,
dysdiadochokinesia), nucleus ambiguus (dysphagia, dysphonia)
13. Brainstem stroke clinical feature
o UMN hemiparesis or tetraparesis (corticospinal tracts)
o Hemisensory or bilateral sensory impairment (medial lemniscus, spinothalamic
tract)
o Diplopia (C.N 3, 4 at midbrain, CN 6 at pons)
o Facial sensory loss (CN 5)
o LMN facial weakness (CN 7)
o Dysphagia, dysarthria (CN 9 and 10 at medulla)
o Ataxia (cerebellum and cerebral connection)
o Horner’s syndrome (meiosis, ptosis, disturbed sweating) : sympathetic fiber in
lateral brainstem
o Altered consciousness (reticular formation)
14. Brainstem stroke
o Locked in syndrome : bilateral infarction in the ventral pons, with or without
medullary involvement, the patient is conscious (intact brainstem reticular
formation) but is mute and paralysed, patient can often move their eyes
because of sparing CN 3 and 4 in the brainstem
o Weber’s syndrome : caused by lesion in one half of the midbrain, resulting an
ipsilateral third nerve palsy (CN 3) and contralateral hemiplegia (descending
pyramidal tract above decussation)
15. Subarachnoid and intracerebral
haemorage
o Subarachnoid haemorage : usually comes from a berry aneurysm arising from
one of the arteries at the base of the brain, around circle of willis
o Intracerebral haemorage : tends to occur in the internal capsule or the pons,
because of the rupture of long thin penetrating arteries
o Both haemorages cause a sudden rise in intracranial pressure, with headache,
vomiting and decrease conscious level, which may followed by the development
of papilloedema
16. Subarachnoid haemorage
o The bleeding irritates the meninges, this causes the
characteristic sudden severe headache and neck
stiffness
o Often a brief loss of consciousness at the moment of
the bleed
17. Intracerebral haemorage
o In the region of internal capsule will cause sudden severe motor, sensory and
visual problems on the contralateral side of the body (hemiplegia,
hemianesthesia and homonymous hemianopia)
o In the pons , sudden loss of motor and sensory function in all four limbs,
associated with disordered brainstem function, accounts for the extremely high
mortality of haemorage in this area