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StrokeSyndromes
| Question | Answer |
|---|---|
| Posterior limb of internal capsule (lacunar infarct) | Contralateral motor impairment without any higher cortical dysfunction and visual field abnormalities |
| Middle cerebral artery occlusion | Contralateral hemiplegia, conjugate eye deviation toward side of infarct, hemianesthesia, homonymous hemianopia, aphasia (dominant hemisphere), hemineglect (non-dominant hemisphere) |
| Anterior cerebral artery occlusion | Contralateral weakness that predominantly affects the lower extremity, abulia, akinetic mutism, emotional disturbances, deviation of head and eyes toward the lesion, sphincter incontinence |
| Vertebrobasilar system lesion | ‘Alternate’ syndromes, with contralateral hemiplegia and ipsilateral cranial nerve involvement |
| Lacunar infarction in the posterior limb of the internal capsule | Unilateral motor deficit (face, arm, and, to a lesser extent, leg); mild dysarthria; NO sensory, visual or higher cortical dysfunction |
| Lacunar infarction in the ventroposterolateral nucleus of the thalamus | Unilateral numbness, paresthesias, and hemisensory deficit involving the face, arm, trunk, and leg |
| Lacunar infarction in the posterior limb of the internal capsule | Weakness that is more prominent in the lower extremity, along with ipsilateral arm and leg incoordination |
| Lacunar stroke at the basis pontis | Hand weakness, mild motor aphasia, NO sensory abnormalities |
| Dominant frontal lobe stroke | Broca’s (expressive or motor) aphasia and unilateral motor deficit ranging from hemiparesis to arm weakness |
| Non-dominant frontal lobe stroke | Unilateral motor deficit ranging from hemiparesis to arm weakness without aphasia |
| Dominant parietal lobe | Dysgraphia, dyscalculia and right/left confusion |
| Nondominant parietal lobe | Construction apraxia, contralateral neglect and anosognosia |
| Dominant temporal lobe stroke | Wernicke’s (receptive) aphasia |
| Occipital lobe stroke | Visual disturbances |
| Medial medullary syndrome/occlusion of the vertebral artery | Contralateral paralysis of the arm and leg, contralateral loss of tactile, vibratory, and position sense, and tongue deviation to the injured side |
| Lateral midpontine syndrome | Impaired sensory and motor function of CN V (the trigeminal nerve) and limb ataxia |
| Medial midpontine syndrome | Ipsilateral limb ataxia, contralateral eye deviation, and paralysis of the face, arm, and leg; variable impairment of touch and position sense |
| Lateral medullary lesion/Wallenberg syndrome | Loss of pain and temperature sensation on the contralateral side of the body, loss of pain and temperature sensation of the face, ipsilateral Horner syndrome, weakness of the palate, pharynx, and vocal cords, and cerebellar ataxia |
| Central midbrain lesion/Weber's syndrome, Benedikt's syndrome, Claude's syndrome, Nothnagel's syndrome or Parinaud's syndrome | Oculomotor paresis and other abnormalities of CN III function; variable cerebellar ataxia and contralateral hemiplegia |
| Occlusion of the ACA | Contralateral weakness in the leg>arm and sensory loss leg>arm; variable urinary incontinence, confusion, and behavioral disturbances |
| Occlusion of the MCA in the dominant hemisphere | Contralateral hemiplegia, hemisensory loss, aphasia, and homonymous hemianopia with eyes deviated toward the cortical lesion |
| Occlusion of the MCA in the non-dominant hemisphere | Contralateral hemiplegia, hemisensory loss, and homonymous hemianopia with eyes deviated toward the cortical lesion; preserved speech, comprehension with confusion, and apraxia with spatial and constructional deficits |
| Occlusion of the PCA | Contralateral homonymous hemianopia, visual hallucinations, and agnosias |
| Occlusion of the penetrating branches of the PCA | Ipsilateral CN III palsy with contralateral hemiplegia (Weber syndrome) or ipsilateral CN III palsy with contralateral ataxia or athetosis (Benedikt syndrome) |
| Occlusion of the paramedian branches of the basial artery | “Locked-in syndrome” presenting as quadriparesis with intact vertical eye movements |
| Occlusion of the posterior inferior cerebellar artery | Wallenberg syndrome, presents as ipsilateral facial sensory loss, contralateral body sensory loss, vertigo, ataxia, dysarthria, dysphagia, and Horner syndrome |
| Occlusion of the major cerebellar arteries | Vertigo, vomiting, nystagmus, and ipsilateral limb ataxia |
Created by:
megankirch
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