Common Clinical Stroke Syndromes based on Artery Involvement

Question 1

1. contralateral weakness of the upper and lower extremities- (lower extremities > face and UE)
2. contralateral numbness of the upper and lower extremities (lower extremities affected more than face and upper extremities)
3. incontinence

Answer 1

anterior cerebral artery

Question 2

contralateral hemineglect

contralateral hemisensory loss of the UE and LE

contralateral hemisensory loss of the face to all modalities

receptive and expressive aphasia (if dominant hemisphere)

contralateral homonymous hemianopsia

contralateral weakness of the UE and LE, but UE + face > LE

Answer 2

middle cerebral artery –> proximal segment

Question 3

expressive aphasia

contralateral hemisensory loss of the face to all modalities

contralateral hemisensory loss of the UE and LE

contralateral weakness of the lower half of the face

contralateral weakness of the upper and lower extremities (UE + face > LE)

Answer 3

Middle cerebral artery - superior division

Question 4

receptive aphasia (if dominant temporal lobe involved)

contralateral constructional apraxia (if non-dom parietal lobe involved)

contralateral quadrantanopsia

contralateral homonymous hemianopsia

Answer 4

middle cerebral a. - inferior division

Question 5

agraphia

acalculia

R-L confusion

finger agnosia

ideomotor apraxia

Answer 5

Gerstman syndrome as the result of a middle cerebral a. - Dominant Inferior Parietal lobe infarct

Question 6

bilateral visual loss

unaware of denial of blindness

Answer 6

Anton Syndrome

Posterior cerebral artery infarct

Question 7

ipsilateral CN III palsy (dilated pupils) with parasympathetic involvement + contralateral weakness of the extremities

Answer 7

Weber syndrome

Posterior cerebral artery infarct

Question 8

ipsilateral cerebellar ataxia

contralateral weakness

contralateral numbness

Answer 8

Lateral Pontine syndrome/Marie-Foix syndrome

Anterior inferior cerebellar artery infarct

Question 9

Ipsilateral facial numbness

contralateral truncal and extremity numbness

ipsilateral palatal pharyngeal and vocal cord paralysis producing dysphagia and dysarthria

vertigo

hiccups

ipsilateral ataxia

Answer 9

PICA posterior inferior cerebellar artery infarct

Wallenburg syndrome/Lateral Medullary syndrome

Question 10

loss of consciousness

OR

quadriplegia with intact consciousness

POSSIBLY only vertical eye movements intact

Answer 10

basilar artery (locked in syndrome)

Question 11

homonymous heminopsia

Answer 11

posterior cerebellar artery