Template:Stroke Syndromes: Difference between revisions
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*Lateral medullary/Wallenberg syndrome: Ipsilateral cerebellar signs, ipsilateral loss of pain/temp of face, ipsilateral Horner's syndrome, contralateral loss of pain/temp over body, dysarthria | *Lateral medullary/Wallenberg syndrome: Ipsilateral cerebellar signs, ipsilateral loss of pain/temp of face, ipsilateral Horner's syndrome, contralateral loss of pain/temp over body, dysarthria | ||
====Internal Capsule==== | ====Internal Capsule and Lacunar Infarcts==== | ||
*May present with either lacunar c/l pure motor or c/l pure sensory | *May present with either lacunar c/l pure motor or c/l pure sensory | ||
*C/l motor plus sensory if large enough or posterior limb of internal capsule | *C/l motor plus sensory if large enough or posterior limb of internal capsule | ||
Revision as of 15:37, 11 July 2015
Anterior Circulation
Anterior Cerebral Artery (ACA)
Signs and Symptoms:
- Contralateral sensory and motor symptoms in the lower extremity (sparing hands/face)
- Left sided lesion: akinetic mutism, transcortical motor aphasia
- Right sided lesion: Confusion, motor hemineglect
Middle Cerebral Artery (MCA)
Signs and Symptoms:
- Hemiparesis, facial plegia, sensory loss contralateral to affected cortex
- Motor deficits found more commonly in face and upper extremity than lower extremity
- Dominant hemisphere involved: aphasia
- Nondominant hemisphere involved: inattention, neglect, dysarthria without aphasia
- Homonymous hemianopsia and gaze preference toward side of infarct may also be seen
Posterior circulation
- Blood supply via the vertebral vertebral artery
- Branches include, Basilar artery, PCA and PICA
Signs and Symptoms:
- Crossed neuro deficits (i.e., ipsilateral CN deficits w/ contralateral motor weakness)
- Multiple, simultaneous complaints are the rule
- 5 Ds: Dizziness (Vertigo), Dysarthria, Dystaxia, Diplopia, Dysphagia
- Isolated events are not attributable to vertebral occlusive disease (e.g. isolated lightheadedness, vertigo, transient ALOC, drop attacks)
Basilar artery
Signs and Symptoms:
- Quadriplegia, coma, locked-in syndrome
Posterior Cerebral Artery (PCA)
Signs and Symptoms:
- Unilateral headache (most common presenting complaint)
- Visual field defects (contralateral homonymous hemianopsia, unilateral blindness)
- Motor function is typically minimally affected
Posterior Inferior Cerebellar Artery (PICA)
Signs and Symptoms:
- Lateral medullary/Wallenberg syndrome: Ipsilateral cerebellar signs, ipsilateral loss of pain/temp of face, ipsilateral Horner's syndrome, contralateral loss of pain/temp over body, dysarthria
Internal Capsule and Lacunar Infarcts
- May present with either lacunar c/l pure motor or c/l pure sensory
- C/l motor plus sensory if large enough or posterior limb of internal capsule
- Clinically to cortical large ACA + MCA stroke - the following signs suggest cortical rather than internal capsule[1]:
- Gaze preference
- Visual field defects
- Aphasia (dominant lesion, MCA)
- Spatial neglect (non-dominant lesion)
- ↑ Internal Capsule Stroke. Stanford Medicine Guide. http://stanfordmedicine25.stanford.edu/the25/ics.html