Strokes & The Rule of 4s || USMLE

​​SUPPORT/JOIN THE CHANNEL: / @dirtymedicine
My goal is to reduce educational disparities by making education FREE.
These videos help you score extra points on medical school exams (USMLE, COMLEX, etc.)
For educational purposes only; NOT medical or other advice.
Some videos contain mild profanity and hyperbole solely used to assist with memorization. Viewer discretion advised.
Opinions are entirely my own.

[@DirtyMedicine]

What you need to take away from this video, AKA, the Rule of 4's!: (1) Divide the CN's up by 4's. They correspond to the sections of the brainstem as you increase in number by 4. For example: CN 1-4 (Midbrain), CN5-8 (Pons), CN9-12 (Medulla). (2) Then, CN's that divide equally into 12 are MIDLINE and those who do NOT divided equally into 12 are LATERAL. For example: CN 3, 4, 6, and 12 are all MIDLINE. CN 5, 7, 9, 10, and 11 are all LATERAL (you omit the first 2 CNs). (3) Next, determine if the deficit is MOTOR or SENSORY. Motor deficits are midline and sensory deficits are lateral (sensory = side). IF YOU UNDERSTAND THESE RULES YOU WILL NEVER GET A BRAINSTEM STROKE QUESTION WRONG!!!! ***Example #3 was removed from the video**

[@heelofentrepreneurs7788]

DirtyUSMLE your chanel is amazinggg , omg ! I just came across of it and after each video everything seems so simple . thanks for doing it , you just an USMLE angel lol 😁😁😁😁😁

[@shwetadabhi2585]

PRESSURE VOLUME LOOPS ... There's no one else but you who can explain such tough concept of cardio... Please help us with that.

[@MeetGrady]

Thx for the videos! Would be nice if you could cover "headache" and/or "thyroid diseases” (not just hypo-/hyperthyroidism)

[@angelofrevengeable]

High-yield microbiology , please ))

[@hmansaria5632]

Great videos! Could you please pin your comment to the top of the list? A lot of people are commenting regarding the CN XI and XII mix-up in the video. Thanks.

[@SanguineMedical]

The person who came up with The Rule of 4s deserves a Nobel Prize for helping out students worldwide

[@user-eh5wz9bm5h]

agree, Dr peter gates 2005

[@ananyapanigrahi3606]

100% ....i always used to skip this topic before I knew the rule of 4!😅

[@LulasSong]

I understood the Rules of Force! 😅 Mine is nerve inflammation the neuroligist said. How's that?

[@andrewfaus6501]

Also, questions may ask which artery is blocked in the stroke so it's good to know which artery supplies which region of the brainstem. Midbrain = PCA Lateral Pons = AICA Medial pons = Basilar Lateral medulla = PICA Medial medulla = ASA

[@shabanalakhair2984]

Thankuuu so much nicely and in a very easily explained way

[@ehadalbusaidi4779]

thanks for sharing , so sweet

[@hebasiddig7475]

Thanku

[@djiraimadjecalvin3398]

Thanks

[@rumsha_khalid]

Lovely!

[@lilmortyy2480]

I think it's also important to remember that tongue deviations are ipsilateral, meaning they're on the same side of the lesion. Like if his tongue is deviated to the left, the lesion is probably on the left side and vice versa

[@nystagmus]

Waleed Murad yup

[@adityapaudel6016]

“ Lick to the lesion”. This is how i usually remember this. always had hard time remembering that

[@TheSteviebobevie]

Uvular deviation is opposite! I like that "Lick the lesion" mnemonic

[@abramc4739]

T-ongue T-owards the lesion Uvul-A A-way from the lesion

[@mk-wb4yl]

As far as I know 4,7,10 th CN causes opposite site involvement rest has ipsilateral site involvement..... As touge is supplied by 12th nerve so ipsilateral involvement will take palce and uvela is supplied by 10th nerve so contralateral involvement wil take place.......plz correct me if um wrong....

[@huntercoates7354]

The vignette should say 'he is unable to move his eyes to the RIGHT' as this is a RIGHT sided stroke and CN motor loss is IPSILATERAL (CN6 Abducens in this case - he can't abduct to the right).

[@haiderMJ]

Yep that’s right, I noticed that too. Thank you for reassurance

[@Nepalimedicine]

Yes, but we should always be aware about 4th nerve which decussates to the opposite side.

[@nunchukgrl2]

I love you. I've read the Rule of 4's, I've watched the Boards and Beyond videos on the Rule of 4's, I've freaked out about the Rule of 4's, and it wasn't until I watched your video that I've been able to just take a deep breath and calm down. Thank you for explaining it so simply and giving examples on how we can apply it.

[@patrickblackwell777]

Spent an entire semester in neuro class and you broke it down better than either of my professors could. Thank you!

[@collinsnjoku5568]

Made me want to cry; I've struggled with answering cva qs for so long.

[@zt2552]

Been practicing (as non neuro doc) for years and I just understood stroke lesions now because of this video! Why did I just discover this? Thank you so much 🙏🏻😊

[@ramyhiekal5191]

maaaan....God bless you brother...thank you for spreading the knowledge.

[@kawlahalarfaj6474]

THIS IS BY FAR THE BEST VIDEO I HAVE SEEN ON THIS TOPIC.. I SPENT HOURS ON MY ANATOMY BOOK WITHOUT A FRACTION OF THE BENEFIT I GOT FROM THIS VIDEO.. THANKS A MILLION !!!!

[@rowellv6606]

Absolutely brilliant. This cleared it up 1000%. Thank you.

[@nystagmus]

9:00 The stroke is medial but you cannot 100% localize it to the pons. CN 3 and CN 6 connect via the MEDIAL LONGITUDINAL FASCICULUS and therefore damage to the MLF can be anywhere from the midbrain to the pons. The stroke might have not hit exclusively CN . But i would guess the pons as well. The second example with CN 12 vs 11 is incorrect however people have mentioned this already OVERALL AMAZINGLY GREAT JOB!

[@cottoncandybomber]

Idk how many lives has he saved! Thank you!

[@michellegiampaoli40]

I am a stroke survivors and mine was caused by stress and eating too much junk food from take away stores like McKay and other fast food outlets in my area. I suffered a stroke at home and my dad got in contact with the local Ambulance service to take me to the new Royal Adelaide Hospital to get treated immediately with medication and surgery to insert a stent into my right side of my brain via my wrist instead of my groin and then transferred to the Flinders Rehabilitation Centre at Bedford Park for the next few months to recover properly and start my Rehab the next day. I had the use of their equipment like the super big treadmill and robotic arm to which was attached to a computer game. It was fun at that time but it was hard work and it made me tired and had no energy to go on further. I was in the Tubrok Ward for the same amount of time. The staff including the doctors,nurses and physiotherapy team who got me up and moving again. After many months in Rehab sessions and I am back at home doing okay and 🚶‍♂️ every day even when it is cold and windy. I will still go out for my walk. If I don't do this my joints will seize up and I will not go for my usual walk for an hour or so.

[@Beastmd]

thank you for sharing your story. i hope you are doing better!

[@sadykhan4763]

Thank you so much !! This is of great help, 5 years of medical school but this single video made it so simple. God bless you !!

[@金子裕介-g7n]

You explained the rules of stroke with easy words.Recently in Japan the examinations of medical license have lots of clinical situation questions. It seems to be natural, but in the past this exams was different from those recently. In the past there are a lot of questions with simple facts ,thus it was like a quiz... The age has been changing...

[@AlanaOkun]

intelligence is not whether you can understand hard topics, but rather if you can distill them and explain them in the simplest way. that is you, sir dirty. thank you!

[@amarawinchester963]

CN 12 is responsible for tongue movement. CN 11 is accessory - head, neck and shoulder movement.

[@AlexM-su6dn]

Dirty, Coming on here post step and comlex to thank you for all these extra points. Between both exams I think I had a good 20-30questions related to this and I’m not joking. Bless you, your team, and everyone you love.

[@medicalstudybuddy2964]

If i could inform medical students and/or physicians of only one medical video out there, this would be it!!

[@idontknowmyname1033]

Hi, for Case #2, the options when you first showed us the question were all related to the midbrain. However, later on, the options were related to the pons. Were the options originally supposed to be related to the midbrain or the pons?

[@novatusbwakea1704]

I also think it's important to remember the level of stroke, ie with cortical strokes we can say right or left stroke with more confidence than if stroke were to happen in internal capsule or other lower structures in the brain, nerve tracts pathways right!!!

[@AliceNLi]

WHAT A GENIUS.

[@soojinlee3527]

I literally breathed a sigh of relief when I saw that you had a video on this...

[@sinduiska190]

Thank you so much for the video,Helpful tips!.I just wanted to point out in The four motor midline syndromes.medial lemniscus isnt motor it is sensory tract

[@MrCabimero]

Brilliant! I have been an Internist for over 30 years. NO ONE ever explained this in this way. Thank you so much !!!!!!

[@arthursaroughian7825]

Tongue deviation is controlled by cranial nerve 12. In this case the left CN 12 would’ve been affected! By the way , you’re doing an amazing job helping us out ! You’re help and time is highly appreciated!

[@DirtyMedicine]

Yes, there was an annotation in the video that addressed this error. I'm not sure if KZbin just doesn't display the annotations anymore, or if you guys are overlooking the subtext. Either way, you are correct.

[@dilandavis8901]

Options changed from Midbrain to pontine in the end. Though pontine was the correct answer anyway. Video was great by the way!

[@sabasaaleha5233]

Its 3:30 am and this video shows up on the top as i open youtube, and i now feel like crying cause you've made my entire neurology easy! 🥺 Thankyouu

[@walichowdhury370]

You are extremely talented. The way you simplified this was amazing. Thank you

[@merblue4776]

thank u so so so much I am literally unable to describe how helpful that was.

[@dacommander]

Dude you’re a life saver, thank you so much

[@tineshacooky4498]

OMG thank you, studying for step 3 and I am reviewing the basics

[@sabaali457]

Just the organization of the nerves has helped so much!!!!! why can't everyone teach this!! Thank you so much!

[@humayounamini3343]

hey man, thanks alot , i was all the time freaking out whenever i see stroke question now i feel much more confident ,,,,

[@Manifesting_Secret_Sketchbook]

SIGNS OF STROKE::: left side neck arm pain, slurry speech, can't smile, face dropping to 1 side, difficult swallowing. REASONS FOR STROKE::: worrying too much, high blood pressure, high diebetes/ sugar levels. CURE/ PREVENTION- diet, exercise. Eat fruits to LOWER blood pressure. For inflammation eat raw root turmeric haldi. Tea bags r giving headaches so can't be trusted. And eating too much sugar and sweetners give dark circles , loss of hair, memory loss. herpes can be caught smoking the hookah pipe. Hepatitis can be cured by drinking 1 glass of coconut water per day.- plz avoid drinking anything straight out of fridge- not good for heart I'm telling you. Lipoma LUMPS gone by fasting for at least 16hrs because fasting eats up cysts n tumours, lipoma lumps, eating omega 3, raw turmeric, drinking more water, exercising, massaging body BEFORE breakfast dinner . Plz AVOID cakes , muffins, doughnuts, fizzy drinks fried foods, soy sauce as they cause LUMPS. GET MOVING- you will notice that tingling sensation on LUMPS after exercising- proof. Also same feeling after drinking fizzy drinks- notice plz LACK OF WATER , CIRCULATION also cause of LUMPS in body. I spent a fortune on homeopathic tablets but to be honest doc put turmeric in those tablets. Surgery never is the cure knew a lady with so many lupms she got so many operations. Never the cure. To prevent strokes eat Apple banana n pears. To lower blood pressure immediately plz eat banana. Fruits can LOWER blood pressure and by drinking more water throughout the day. - plz avoid drinking n eating while standing n walking it's bad for the heart and joints. I eat on the floor/ carpet/ rug. Fibroids can be prevented by Avoiding chicken liver, tomato seeds, white flour so doughnuts cakes white sugars. Plz note too much lack of FERRITIN and IRON in body may cause heart attack so get eating beetroot, spinach carrots plz- avoid for few hours coffee milk, cake, doughnuts, cream, tea ,wholemeal bread, pitta as these STOP iron absorption so not your best friend

[@ShanilR]

Internal carotid meets at base of skull branch into MCA & ACA (anterior communicating artery) Vertebral artery give rise basilar than to posterior cerebral (posterior communicating artery)

[@masayuangelanggraini6144]

Thank you, man. You don't know how much it helps me. I am not good with basic neurology. And this helps me tremendously.

[@acingmedicine]

The best video on brainstem lesions so far, tysm!

[@gogoblyn]

You make great videos too 😃

[@acingmedicine]

@@gogoblyn Wow Amrinder, thank you so much!

[@sandeeeyx3]

Wow this was hands down one of the best videos I've watched. Great visual aids and you explained it so simply. THANK YOU SO MUCH!!!

[@danktankdragkings7117]

Thank you so very much. I am a 2 major things survivor and 3 subsiquent concussions that I know of. I would love to be a neurologist (I know the material) I just can't afford the school nor do I have the attention span to go to college anymore. I really appreciate having this information available both to understand myself and to follow my passion even if I can't make it a career.

[@Manifesting_Secret_Sketchbook]

SIGNS OF STROKE::: left side neck arm pain, slurry speech, can't smile, face dropping to 1 side, difficult swallowing. REASONS FOR STROKE::: worrying too much, high blood pressure, high diebetes/ sugar levels. CURE/ PREVENTION- diet, exercise. Eat fruits to LOWER blood pressure. For inflammation eat raw root turmeric haldi. Tea bags r giving headaches so can't be trusted. And eating too much sugar and sweetners give dark circles , loss of hair, memory loss. herpes can be caught smoking the hookah pipe. Hepatitis can be cured by drinking 1 glass of coconut water per day.- plz avoid drinking anything straight out of fridge- not good for heart I'm telling you. Lipoma LUMPS gone by fasting for at least 16hrs because fasting eats up cysts n tumours, lipoma lumps, eating omega 3, raw turmeric, drinking more water, exercising, massaging body BEFORE breakfast dinner . Plz AVOID cakes , muffins, doughnuts, fizzy drinks fried foods, soy sauce as they cause LUMPS. GET MOVING- you will notice that tingling sensation on LUMPS after exercising- proof. Also same feeling after drinking fizzy drinks- notice plz LACK OF WATER , CIRCULATION also cause of LUMPS in body. I spent a fortune on homeopathic tablets but to be honest doc put turmeric in those tablets. Surgery never is the cure knew a lady with so many lupms she got so many operations. Never the cure. To prevent strokes eat Apple banana n pears. To lower blood pressure immediately plz eat banana. Fruits can LOWER blood pressure and by drinking more water throughout the day. - plz avoid drinking n eating while standing n walking it's bad for the heart and joints. I eat on the floor/ carpet/ rug. Fibroids can be prevented by Avoiding chicken liver, tomato seeds, white flour so doughnuts cakes white sugars. Plz note too much lack of FERRITIN and IRON in body may cause heart attack so get eating beetroot, spinach carrots plz- avoid for few hours coffee milk, cake, doughnuts, cream, tea ,wholemeal bread, pitta as these STOP iron absorption so not your best friend

[@ShoaibAhmed-ix5vp]

A big salute to this person who made this I was so dam worried and was hiding always from these topic .thanks to this

[@Hadi-hv3wx]

maan this video is so useful. after struggling many years with stroke syndromes, it's a peace of cake now

[@Manifesting_Secret_Sketchbook]

SIGNS OF STROKE::: left side neck arm pain, slurry speech, can't smile, face dropping to 1 side, difficult swallowing. REASONS FOR STROKE::: worrying too much, high blood pressure, high diebetes/ sugar levels. CURE/ PREVENTION- diet, exercise. Eat fruits to LOWER blood pressure. For inflammation eat raw root turmeric haldi. Tea bags r giving headaches so can't be trusted. And eating too much sugar and sweetners give dark circles , loss of hair, memory loss. herpes can be caught smoking the hookah pipe. Hepatitis can be cured by drinking 1 glass of coconut water per day.- plz avoid drinking anything straight out of fridge- not good for heart I'm telling you. Lipoma LUMPS gone by fasting for at least 16hrs because fasting eats up cysts n tumours, lipoma lumps, eating omega 3, raw turmeric, drinking more water, exercising, massaging body BEFORE breakfast dinner . Plz AVOID cakes , muffins, doughnuts, fizzy drinks fried foods, soy sauce as they cause LUMPS. GET MOVING- you will notice that tingling sensation on LUMPS after exercising- proof. Also same feeling after drinking fizzy drinks- notice plz LACK OF WATER , CIRCULATION also cause of LUMPS in body. I spent a fortune on homeopathic tablets but to be honest doc put turmeric in those tablets. Surgery never is the cure knew a lady with so many lupms she got so many operations. Never the cure. To prevent strokes eat Apple banana n pears. To lower blood pressure immediately plz eat banana. Fruits can LOWER blood pressure and by drinking more water throughout the day. - plz avoid drinking n eating while standing n walking it's bad for the heart and joints. I eat on the floor/ carpet/ rug. Fibroids can be prevented by Avoiding chicken liver, tomato seeds, white flour so doughnuts cakes white sugars. Plz note too much lack of FERRITIN and IRON in body may cause heart attack so get eating beetroot, spinach carrots plz- avoid for few hours coffee milk, cake, doughnuts, cream, tea ,wholemeal bread, pitta as these STOP iron absorption so not your best friend

[@EveryDayKit]

The second question given for brainstem strokes has two different sets of answer choices. The first set are all midbrain and when the answers are revealed they all say pontine.

[@maymunmohiuddin7529]

Yes, I was confused about that too

[@kelumpathirana8210]

Thanks for the video..10.59 it shoud be CN 12 ( 11 is supply to shoulder muscles not to tongue )

[@rojanpreranauk]

i am thinking the same, doesnt fit here.

[@nouranm1224]

Thank you so much, this is the first time i understand stroke syndromes.

[@evagarringer4674]

Language disorders are associated with MCA rather than PCA lesions and specifically left MCA (LEFT = LANGUAGE). Stem MCA initially presents as global aphasia (comprehension = NO, fluent = NO, repetition = NO, superior division MCA with Broca's aphasia (comprehension = YES, fluent = NO, repetition = NO), inferior MCA with Wernicke's aphasia (comprehension = NO, fluent = YES, repetition = NO). PCA lesions can affect the thalamus and produce contralateral hemianesthesia, or more rarely a disconnect syndrome alexia without agraphia (L PCA - right hemisphere can't read but can't pass visual info to L hemisphere, which can read). Very nice in general!!

[@padippistkallan884]

The best, smart teaching , i watch a lot of a topic to find wich video is best. but after comparing with others finally I find your videos as the best , if there is your video, there that will be the best out there

[@sarahgroleau4127]

Thank you so much, this video is amazing, quick easy, organized and to the point, I LOVE it.

[@adrenaline2288]

True blue

[@SimranAgain]

You are a god Dirty! A literal god for making this video!

[@muhammadmahmood734]

best stoke localisation video i have seen so far. thankyou

[@anapereira5170]

🙂Muito obrigado pelo que fez pela minha mãe,dá gosto ver todos os seus vídeos doutor. Isso aí ! Até cortar os próprios defeitos pode ser perigoso. Nunca se sabe qual é o defeito que sustenta nosso edifício inteiro.

[@emilyb5557]

Great video & honest response re mistake! I wish in the UK MRCP they did the same they of putting the named syndrome in brackets. We can be asked Paranauds & need to remember it's X location rather than be able to show we can localise correctly!

[@michellegiampaoli40]

In Australia the Emergency number is triple zero and that would make contact with the local Ambulance service in your town city or state. Never use the 911 number because this is an American service and not an Australian service.

[@sherir6588]

Amazing video! This was so helpful when I took my SCRN (Stroke Certification) exam.

[@7ayaat1]

I am truly thrilled! Ur teaching is a blessing!! Thank you!

[@melaninmonroe007]

I know yall didn't invent this, but you explained it so well. Yall should re-shoot and correct the MCQ mistakes. Other than that, THANK YOU.

[@DirtyMedicine]

Yeah I've been thinking of re-doing the video but with the captions added I think it serves its purpose. After all, if you understand the rules (presented before any of the examples) you are golden !!!

[@tigermoth8902]

@DirtyUSMLE Great video! Just a small question, in case 3 the tongue deviation is due to CN12, wouldn't that imply a MEDIAL stroke not a lateral one? Sorry if I am being stupid. Thanks

[@danielshin1400]

I think you are right. The video is wrong...CN 12 implies medial medullary stroke. Dont trust 100% what this video is saying.

[@cristobalalmendares2645]

Thanks you Dirty, greetings from Habana, Cuba. I hope you continues making videos like this👍

[@IM.MEDICAL]

Thanks for spreading the knowledge! 👍

[@MrCabimero]

I respectfully request that you post a video with some more case study questions. PLEASE!!!!!!!

[@aasmaa27]

Really helpful!!! Hands down Best video on strokes. Thankyou

[@harisrahman545]

Wernicke's / Broca's area supplied by MCA, so MCA stroke causes language issues (says PCA in this vid) Source: uworld

[@patelharsha5236]

In case #2 before explanation option were midbrain which is i think typing mistake but you correct it after explanation 🙌🙌. Btw nice & crisp concise explanation , Thank you 🙏

[@positive_hassan8252]

Thank you so much ,GOD bless you with more wealth , Health and knowledge

[@khadifoxx]

This video is such a life saver. Can you please do a review of the cranial nerves.

[@magicstix0r]

You know, when you think about it, technically every death is a massive stroke, since the person isn't really dead until the brain is...

[@meramahmoud8072]

Thank you sooo much!! The illustration was very informative and the questions were a very helpful application

[@johns3413]

Love the video but the Medial Lemniscus is sensory and is placed in the motor syndromes. Small exception to the rule of 4 Ms that wasnt mentioned.

[@gabrielcollie7600]

great video but you did not mention the vessels that are being occluded at all

[@arthursaroughian7825]

Appreciate all your help buddy! Wondering if you made videos on rapid histology and biochemistry cases or videos..? Thanks for all you do for Usmle folks Appreciate your time

[@MafiaDiesel]

can somebody explain why case 2 is Right medial pontine and not the left? i thought the Left CN VI nuclei control the left Lateral Rectus muscle

[@imsuperioroso]

you need a video talking about which arteries corresponds to which parts of the brainstem. When the answer choices are things like posterior inferior cerebellar artery this video doesn't help :(

[@Disisluke50]

Look it up yourself man, this video is extremely helpful.

[@hellfire6372]

Basilar artery

[@hshmn]

Lateral/Medial Midbrain is PCA Lateral Pons is AICA - Medial Pons is Basilar Artery Lateral Medulla is PICA - Medial Medulla is Anterior Spinal Artery Doing this off memory from B&B - hopefully no mistake

[@doctortalks5031]

Love it . Saved my shelf exam

[@mbk928]

WOW, Straight THANK YOU

[@valentinaguzman1459]

Thanks!!! Now everything is easier

[@MarieArenbiCarillanes]

ang talino! ang galing! salamat sa tulong mo!!!

[@amnazubair73]

Thank you. I never understood stroke like this before.

[@Manifesting_Secret_Sketchbook]

SIGNS OF STROKE::: left side neck arm pain, slurry speech, can't smile, face dropping to 1 side, difficult swallowing. REASONS FOR STROKE::: worrying too much, high blood pressure, high diebetes/ sugar levels. CURE/ PREVENTION- diet, exercise. Eat fruits to LOWER blood pressure. For inflammation eat raw root turmeric haldi. Tea bags r giving headaches so can't be trusted. And eating too much sugar and sweetners give dark circles , loss of hair, memory loss. herpes can be caught smoking the hookah pipe. Hepatitis can be cured by drinking 1 glass of coconut water per day.- plz avoid drinking anything straight out of fridge- not good for heart I'm telling you. Lipoma LUMPS gone by fasting for at least 16hrs because fasting eats up cysts n tumours, lipoma lumps, eating omega 3, raw turmeric, drinking more water, exercising, massaging body BEFORE breakfast dinner . Plz AVOID cakes , muffins, doughnuts, fizzy drinks fried foods, soy sauce as they cause LUMPS. GET MOVING- you will notice that tingling sensation on LUMPS after exercising- proof. Also same feeling after drinking fizzy drinks- notice plz LACK OF WATER , CIRCULATION also cause of LUMPS in body. I spent a fortune on homeopathic tablets but to be honest doc put turmeric in those tablets. Surgery never is the cure knew a lady with so many lupms she got so many operations. Never the cure. To prevent strokes eat Apple banana n pears. To lower blood pressure immediately plz eat banana. Fruits can LOWER blood pressure and by drinking more water throughout the day. - plz avoid drinking n eating while standing n walking it's bad for the heart and joints. I eat on the floor/ carpet/ rug. Fibroids can be prevented by Avoiding chicken liver, tomato seeds, white flour so doughnuts cakes white sugars. Plz note too much lack of FERRITIN and IRON in body may cause heart attack so get eating beetroot, spinach carrots plz- avoid for few hours coffee milk, cake, doughnuts, cream, tea ,wholemeal bread, pitta as these STOP iron absorption so not your best friend

[@jacintoperez4189]

Hey! Can you make a video explaining the Bias and Study Errors? please.

[@homehome8503]

Yes please

[@حيدرسعدعلوانعباس]

What a channel what a video 😍 You are amazing dear

[@bellasantie]

AWESOME, JUST AMAZING.. THANKS 🙏🏾 SO MUCH!!!!

[@yashranga4589]

thanks dude u r a life saver

[@rit2557]

Fantastic!!!!!!!!!!! No words!! Thank youuuuu🙏🙏🙏🙏

[@sammionne239]

AMAZING video but please add annotation correcting case 3, cranial nerve should be 12 not 11 since there is tongue deviation to right!?!?

[@samueltiffany2665]

Yeah and that would mean that the stroke affected both medial and lateral regions of the right side of the medulla.

[@hallilafrankie272]

Thanks for this video. Helped me a lot more than BnB did for this topic.

[@raihanmohammedmohiuddin9323]

amazingly done and beautifully created

[@nandhaganesh]

Doubt regarding Case 2. If the CN VI nuclei is being involved, don't we get Ipsilateral palsy? So the movement of eyes towards right only should be impaired if it's a right sided involvement of pons, isn't it?

[@aarnoman1088]

Correct: It's ipsilateral if it involves the nucleus or cranial nerves.

[@khaledelmagraby9090]

@@aarnoman1088 yes u r right :)

[@ProfessorSerperior]

Yea "cross findings" is a classic sign of brainstem stroke. AKA left motor symptoms with right cranial nerve deficits

[@kevinsurat5319]

@@ProfessorSerperior "cross findings" is related to corticobulbar tract EXCEPT cranial nerve III, IV, VI, XII, so they are different from diffuse motor stroke, so this case would be left brain stem stroke with right medial pontine stroke

[@judahglogauer6517]

First Aid says Language is an MCA issue. Aphasia occurs during an MCA stroke if patient strokes in dominant hemisphere, usually the left (Ref: FA, 2017 p. 484) PCA stroke does cause vision issues though (Re: FA, 2017 P. 485)

[@DirtyMedicine]

if the patient is right handed (and therefore the left hemisphere is dominant) then a Left MCA stroke can cause aphasia.

[@robbiedart7422]

@@DirtyMedicine Is it not true though that speech is more associated with the MCA than the PCA like it says in the video? My understanding of where Broca's and Wernicke's area are would suggest an MCA infarct would be more likely to affect them also.

[@atlas002]

Video was awesome I tried to solve 2nd ques but i thought answer should be out of options & it was (Check 6:47 & 8:23)

[@zakzia6139]

for the second case, aren't coritospinal, spinothalamic and DCML tracts contralateral, and CN defecitis ipsilateral in the brain stem? i.e they should not be able to move eye laterally to the right

[@prakhargoyal_6483]

Same doubt, lateral rectus of the right side should be paralysed and left sided corticospinal tract. Please clarify.

[@alhasanmd7305]

Correct.

[@HAODIDI]

i had same problem. Answer should be left medial pontine. Generally it a great presentation

[@thechemicalorchestra]

I thought so too!

[@usamakhalid8424]

Yes it should be ipsilateral gaze palsy. Cant look towards lesion in medial pontine stroke.

[@MMATIN-m8c]

In your classification lacunar strokes are missing, they are not cortical or brain stem stroke!

[@imjustlivinglife1747]

best video. 2nd best is probably the high yield drugs video

[@factsworthkn0w]

So helpfull and soo simple approach to learn about stroke cases salute u sir thanks so much ❤

[@rocktune2719]

made it like a breeze. Thanks u are awesome

[@edwinshumaker5849]

you are a blessing

[@sitthuson]

@6:58 the Questions don't have Pons as the choices given, me knowing that LR6 was an issue. but at @8:23 the choices were corrected

[@MuhammadAli-ml9bt]

WOW GREAT YOU NAILED IT SIMPLIFIED SIMPLIFIED SIMPLIFIED

[@johnetntemgwa4344]

Woww. Excellent video. Thanks. You just made a difficult concept as easy as ABC. Thanks a lot.

[@lumiahtisaari148]

This was fantastic!!! What a great explanation! Thank you so much

[@DavidGarcia-sm4uo]

According to Kaplan Q-Bank: Stroke In ACA do not produce Alterated Mental Status.

[@DirtyMedicine]

AMS is an independent symptom in any acute ischemic event. Source: www.ncbi.nlm.nih.gov/pmc/articles/PMC2714497/