Brain and its blood supply

Question 1

Anterior cerebral artery (ACA) occlusion

Answer 1

Occlusion of the anterior cerebral artery may result in the following defects

Hemiparesis of the contralateral foot and leg (more severely than the arm)
Sensory loss of the contralateral foot and leg
Motor dysphasia

If stroke occurs prior to the anterior communicating artery it is usually well tolerated secondary to collateral circulation

Question 2

Middle cerebral artery (MCA) occlusion

Answer 2

Occlusion of the middle cerebral artery may result in the following defects

Hemiparesis of the contralateral face and limbs
Sensory loss of contralateral face and limbs
Dysphasia (when dominant hemisphere affected)
Contralateral neglect
Homonymous hemianopia or quadrantanopia
Dorsolateral prefrontal dysfunction

Question 3

Posterior cerebral artery (PCA) occlusion

Answer 3

Occlusion of the posterior cerebral artery may result in the following defects

Alexia without agraphia (left PCA)
Contralateral loss of pain and temperature sensation
Contralateral hemianopia
Prosopagnosia
Ipsilateral cranial nerve defects (V, VIII, IX, X, & XI)
Horner’s syndrome

Question 4

Posterior inferior cerebellar artery occlusion/ infarct (aka Wallenberg’s syndrome, and lateral medullary syndrome) results in the following:-

Answer 4

Sudden onset of dizziness and vomiting
Ipsilateral facial sensory loss - pain and temperature
Contralateral sensory loss - pain and temperature of the limbs and trunk
Nystagmus to the side of the lesion
Ipsilateral limb ataxia
Dysphagia and dysarthria
Ipsilateral pharyngeal and laryngeal paralysi

Question 5

Caudate nucleus

Answer 5

The caudate nucleus receives its blood supply mainly through the deep penetrators of the anterior and middle cerebral arteries.

The symptoms and signs from caudate infarctions vary from report to report. Behavioural symptoms, especially abulia and agitation, loss of executive abilities, and motor weakness are most common.