CVA Clinical Syndromes Flashcards
What lobe is affected with ACA stroke? What does this cause?
- frontal lobe which causes cognitive deficits like: Agitation Memory impairments Executive Function impairments Attention deficits Emotional lability/lack of emotional regulation Motor perseveration Lack of spontaneity Delayed processing
What part of the body is impacted more with ACA stroke? What side will symptoms present on?
LE > UE b/c interior part of brain (homunculus)
pt will have contralateral hemiplegia and hemisensory loss
What are some common signs and symptoms of an ACA stroke?
- What side will they occur on?
- apraxia - difficulty w/ skilled movements (dominant/left > nondominant/right)
- transcortical aphasia - stuttering speech - damage to sup. motor area
- contralateral grasp and sucking reflexes
- urinary incontinence
- visual deficits
Medial medullary syndrome stroke artery involved
vertebral artery
Lateral medullary syndrome (Wallenberg’s Syndrome) artery involved
PICA
Medial Inferior Pontine Syndrome artery involved
Basilar artery
Lateral Inferior Pontine Syndrome artery involved
AICA
What is the only stroke that has hearing involvement?
lateral inferior pontine syndrome
lateral superior pontine syndrome artery involved
superior cerebellar artery
vertebrobasilar artery syndrome (locked-in syndrome) artery involved
basilar artery/posterior circulation
lacunar infarcts artery involved
lenticulostriate arteries off MCA
What part of the body is impacted more with MCA stroke? What side will symptoms present on?
- UE > LE
- contralateral hemiplegia and hemisensory loss
What are common S & S of MCA stroke?
- dysarthria (slurring of speech bc of facial deficits)
- apraxia and aphasia (dominant > nondominant)
- perceptual deficits (nondominant > dominant) - agnosias, neglect, spatial disorientation
- behavior impairments
- visual deficits
- contralateral dysconjugate gaze
- sensory ataxia
Which side of the brain is more commonly affected by MCA apraxia and aphasia?
dominant (left) > nondominant (right)
Which side of the brain is more commonly affected by perceptual deficits after MCA stroke?
What kind of deficits are they?
nondominant (right) > dominant (left)
- agnosias, neglect, spatial disorientation
If MCA stroke occurred on the left side of the brain, what kind of behavior would the patient have?
dominant side - cautious behavior
If MCA stroke occurred on the right side of the brain, what kind of behavior would the patient have?
nondominant side - impulsive behavior
What kind of impairments would you see with Superior MCA stroke?
- motor impairments (motor cortex)
- behavior impairments (frontal)
- perception impairments (parietal)
What kind of impairments would you see with Inferior MCA stroke?
- walkie talkie - walk normally w/ no motor impairments but talk gibberish due to Wernicke’s and speech impairments
- may have some facial impairments based on the homunculus
What are common S & S of lacunar infarcts? What occurs if internal capsule or basal ganglia are damaged?
motor impairments
- NO SENSORY, no behavior, no coordination if internal capsule damaged
- Significant motor control & motor planning deficits if basal ganglia damaged
What are common S & S of PCA stroke?
- vision
- visual agnosia (dominant > nondominant)
- Prosopagnosia (face blindness)
- dyslexia
- memory (temporal)
- Topographical disorientation (nondominant > dominant)
What side is affected more with PCA stroke when it comes to visual agnosia and Topographical disorientation?
- visual agnosia - dominant > nondominant
- Topographical disorientation - nondominant > dominant
What will you see with deep PCA stroke?
- thalamic pain
- Spontaneous pain & dysesthesias
- involuntary movements
- contralateral hemiplegia
- motor and sensory impairments
What is the cause of watershed infarcts?
severe/sudden drops in BP
