stroke Flashcards
Anterior cerebral artery stroke
Contralateral hemiparesis and sensory loss, lower extremity > upper
Middle cerebral artery stroke
Contralateral hemiparesis and sensory loss, upper extremity > lower
Contralateral homonymous hemianopia
Aphasia
Posterior cerebral artery stroke
Contralateral homonymous hemianopia with macular sparing
Visual agnosia
Weber’s syndrome (branches of the posterior cerebral artery that supply the midbrain) stroke
Ipsilateral CN III palsy
Contralateral weakness of upper and lower extremity
Posterior inferior cerebellar artery (lateral medullary syndrome, Wallenberg syndrome) stroke
Ipsilateral: facial pain and temperature loss
Contralateral: limb/torso pain and temperature loss
Ataxia, nystagmus
Anterior inferior cerebellar artery (lateral pontine syndrome) stroke
Symptoms are similar to Wallenberg’s (see above), but:
Ipsilateral: facial paralysis and deafness
Retinal/ophthalmic artery stroke
Amaurosis fugax
Basilar artery stroke
‘Locked-in’ syndrome
Pontine
Miosis, absent horizontal eye movements, quadriplegia. Occurs secondary to chronic hypertension.
The following criteria should be assessed when classifying strokes by the oxford stroke classification.
- unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
- homonymous hemianopia
- higher cognitive dysfunction e.g. dysphasia
Total anterior circulation infarcts (TACI, c. 15%)
Involves middle and anterior cerebral arteries
3 of the criteria are present
Partial anterior circulation infarcts (PACI, c. 25%)
involves smaller arteries of anterior circulation e.g. upper or lower division of middle cerebral artery
2 of the criteria are present
Lacunar infarcts (LACI, c. 25%)
involves perforating arteries around the internal capsule, thalamus and basal ganglia
presents with 1 of the following:
1. unilateral weakness (and/or sensory deficit) of face and arm, arm and leg or all three.
2. pure sensory stroke.
3. ataxic hemiparesis
Posterior circulation infarcts (POCI, c. 25%)
involves vertebrobasilar arteries
presents with 1 of the following:
1. cerebellar or brainstem syndromes
2. loss of consciousness
3. isolated homonymous hemianopia
Other recognised patterns of stroke?
Lateral medullary syndrome (posterior inferior cerebellar artery)
aka Wallenberg’s syndrome
-ipsilateral: ataxia, nystagmus, dysphagia, facial numbness, cranial nerve palsy e.g. Horner’s
-contralateral: limb sensory loss
Weber’s syndrome
-ipsilateral III palsy
-contralateral weakness
