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  #1  
Old 01-03-2012
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Neuro Locate this stroke and area affected!

An 83-year-old female was admitted to the emergency room following a stroke. Sometime after she regained consciousness, a neurological examination revealed that the application of mild tactile stimulation on the right arm was extremely painful, while the remainder of the neurological examination was relatively normal for an individual of her age. Which of the following regions of the central nervous system constitutes the primary origin of the neurons that provide sensory input into the region affected by the stroke?

A. Lateral medulla
B. Medial medulla
C. Midbrain periaqueductal gray
D. Spinal cord
E. Dorsomedial pons

For the same patient.
Where was the most likely locus of the stroke?

A. Right precentral gyrus
B. Left precentral gyrus
C. Right ventroposterolateral thalamus
D. Left ventroposterolateral thalamus
E. Left ventroposteromedial thalamus
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  #2  
Old 01-03-2012
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Spinal cord...
Left VPL thalamus....
I m not very sure about the spinal cord though..but pz explain ur ans.will appteciate.thanks
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Old 01-04-2012
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Quote:
Originally Posted by scopusmount View Post
An 83-year-old female was admitted to the emergency room following a stroke. Sometime after she regained consciousness, a neurological examination revealed that the application of mild tactile stimulation on the right arm was extremely painful, while the remainder of the neurological examination was relatively normal for an individual of her age. Which of the following regions of the central nervous system constitutes the primary origin of the neurons that provide sensory input into the region affected by the stroke?

A. Lateral medulla
B. Medial medulla
C. Midbrain periaqueductal gray
D. Spinal cord
E. Dorsomedial pons

For the same patient.
Where was the most likely locus of the stroke?

A. Right precentral gyrus
B. Left precentral gyrus
C. Right ventroposterolateral thalamus
D. Left ventroposterolateral thalamus
E. Left ventroposteromedial thalamus
T1 dermatome....spinal cord lesion
Not sure the second part!
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Old 01-04-2012
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Quote:
Originally Posted by scopusmount View Post
An 83-year-old female was admitted to the emergency room following a stroke. Sometime after she regained consciousness, a neurological examination revealed that the application of mild tactile stimulation on the right arm was extremely painful, while the remainder of the neurological examination was relatively normal for an individual of her age. Which of the following regions of the central nervous system constitutes the primary origin of the neurons that provide sensory input into the region affected by the stroke?

A. Lateral medulla
B. Medial medulla
C. Midbrain periaqueductal gray
D. Spinal cord
E. Dorsomedial pons

For the same patient.
Where was the most likely locus of the stroke?

A. Right precentral gyrus
B. Left precentral gyrus
C. Right ventroposterolateral thalamus
D. Left ventroposterolateral thalamus
E. Left ventroposteromedial thalamus

The answer for first one is C Midbrain and periaqueductal gray area because periaqueductal area plays a role in modulation of pain and release endorphins in reaction to pain and it is close to thalamus thus affected by stroke .

Ans to 2nd one is D Left ventroposterolateral thalamus becoz the pain is in the right arm and the 2nd order neurons cross in medulla before reaching the VPL of thalamus ...

The above case is a Dejerine–Roussy syndrome .. hope this helps
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Old 01-04-2012
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Help I go...

For D (spinal cord) and D (LVP Thalamus)... Lets wait for the answer.
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Old 01-04-2012
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D spinothalamic tract responsible for pain and temperature senastion.(so spinal cord)

D for second- is pretty much what hitman said.
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Old 01-05-2012
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Quote:
Originally Posted by Poonam aslam View Post
Spinal cord...
Left VPL thalamus....
I m not very sure about the spinal cord though..but pz explain ur ans.will appteciate.thanks
A stroke involving the ventral posterolateral nucleus of the thalamus can produce an entity called the Dčjčrine-Roussy syndrome, or thalamic pain syndrome. There is contralateral pain or discomfort out of proportion to the stimulus on the affected side of the body. Emotional disturbance aggravates the response. Some patients describe the sensation as knifelike or hot. As the deficit (numbness) resolves, the pain may lessen. This syndrome may also occur in lesions of the parietal white matter and is thought to occur as a result of an imbalance of afferent sensory impulses. Sensation of the limbs and trunk are projected through the lateral spinothalamic tract (originating in the dorsal horn of spinal cord) through the ventral posterolateral nucleus of the thalamus to the somatosensory cortex. It is an area with a high density of opiate receptors and opioidergic neurons and is thought to represent a key area in gating pain.
stroke involving the ventral posterolateral nucleus of the thalamus can produce an entity called the Dčjčrine-Roussy syndrome, or thalamic pain syndrome. There is contralateral pain or discomfort out of proportion to the stimulus on the affected side of the body. Emotional disturbance aggravates the response. Some patients describe the sensation as knifelike or hot. As the deficit (numbness) resolves, the pain may lessen. This syndrome may also occur in lesions of the parietal white matter and is thought to occur as a result of an imbalance of afferent sensory impulses. Sensation of the limbs and trunk are projected through the lateral spinothalamic tract (originating in the dorsal horn of spinal cord) through the ventral posterolateral nucleus of the thalamus to the somatosensory cortex. It is an area with a high density of opiate receptors and opioidergic neurons and is thought to represent a key area in gating pain.
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  #8  
Old 01-06-2012
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Yaaay..but thanks,,,I didn't know about this syndrome..
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