Effects of Strokes Flashcards
MCA
Area of lesion:
Motor cortex - upper limb and face.
Sensory cortex - upper limb and face.
Temporal lobe (Wernicke’s area); frontal lobe (Broca’s area).
Symptoms:
Contralateral paralysis - upper limb and face.
Contralateral loss of sensation - upper limb and face.
Aphasia if in dominant (usually left) hemisphere. Hemineglect if lesion affects non dominant (usually right) side.
Notes:
ACA
Area of lesion:
Motor cortex - lower limb.
Sensory cortex - lower limb.
Symptoms:
Contralateral paralysis - lower limb.
Contralateral loss of sensation - lower limb.
Notes:
Lateral striate artery
Area of lesion:
Striatum, internal capsule.
Symptoms:
Contralateral hemiparesis/hemiplegia.
Notes:
Common location of lacunar infarcts, 2 degree to unmanaged hypertension.
ASA
Area of lesion:
Lateral corticospinal tract.
Medial lemniscus.
Caudal medulla - hypoglossal nerve.
Symptoms:
Contralateral hemiparesis - lower limbs.
Decreased contralateral proprioception.
Ipsilateral hypoglossal dysfunction (tongue deviates ipsilaterally).
Notes:
Stroke commonly bilateral.
Medial medullary syndrome - caused by infarct of paramedian branches of ASA and vertebral arteries.
PICA
Area of lesion:
Lateral medulla - vestibular nuclei, lateral spinothalamic tract, spinal trigeminal nucleus, nucleus ambiguus, sympathetic fibers, inferior cerebellar peduncle.
Symptoms:
Vomiting, vertigo, nystagmus; decreased pain and temperature sensation to limbs/face; dysphagia, hoarseness, decreased gag reflex; ipsilateral Horner’s syndrome; ataxia, dysmetria.
Notes: Lateral medullary (Wallenberg's) syndrome. Nucleus ambiguous effects are specific to PICA lesions. "Don't pick a (PICA) horse (hoarseness) that can't eat (dysphagia)."
AICA
Area of lesion:
Lateral pons - Cranial nerve nuclei; vestibular nuclei, facial nucleus, spinal trigeminal nucleus, cochlear nuclei, sympathetic fibers.
Middle and inferior cerebellar peduncles.
Symptoms:
Vomiting, vertigo, nystagmus. Paralysis of face, decreased lacrimation, salivation, decreased taste from anterior 2/3 of tongue, decreased corneal reflex. Face - decreased pain and temperature sensation. Ipsilateral decreased hearing. Ipsilateral Horner’s syndrome.
Ataxia, dysmetria.
Notes:
Lateral pontine syndrome. Facial nucleus effects are specific to AICA lesions. “Facial droop means AICA’s pooped.”
PCA
Area of lesion:
Occipital cortex, visual cortex.
Symptoms:
Contralateral hemianopia with macular sparing.
Notes:
AComm
Area of lesion:
Common site of saccular (berry) aneurysm -> impingement on cranial nerves.
Symptoms:
Visual field defects.
Notes:
Lesions are typically aneurysms, not strokes.
PComm
Area of lesion:
Common site of saccular (berry) aneurysm.
Symptoms:
CN III palsy - eye is “down and out” with ptosis and pupil dilation.
Notes:
Lesions are typically aneurysms, not strokes.
