Stroke

Question 1

Primary intracerebral haemorrhage (PICH, c. 10%)

Answer 1

Presents with headache, vomiting, loss of consciousness

Question 2

Total anterior circulation infarcts (TACI, c. 15%)

Answer 2

Involves middle and anterior cerebral arteries
Hemiparesis/hemisensory loss
Homonymous hemianopia
Higher cognitive dysfunction e.g. Dysphasia

Question 3

Partial anterior circulation infarcts (PACI, c. 25%)

Answer 3

Involves smaller arteries of anterior circulation e.g. upper or lower division of middle cerebral artery
Higher cognitive dysfunction or two of the three TACI features

Question 4

Lacunar infarcts (LACI, c. 25%)

Answer 4

Involves perforating arteries around the internal capsule, thalamus and basal ganglia
Present with either isolated hemiparesis, hemisensory loss or hemiparesis with limb ataxia

Question 5

Posterior circulation infarcts (POCI, c. 25%)

Answer 5

Vertebrobasilar arteries
Presents with features of brainstem damage
Ataxia, disorders of gaze and vision, cranial nerve lesions

Question 6

Lateral medullary syndrome (posterior inferior cerebellar artery)

Answer 6

Wallenberg’s syndrome
Ipsilateral: ataxia, nystagmus, dysphagia, facial numbness, cranial nerve palsy
Contralateral: limb sensory loss

Question 7

Weber’s syndrome

Answer 7

Ipsilateral III palsy

Contralateral weakness

Question 8

Anterior cerebral artery

Answer 8

Contralateral hemiparesis and sensory loss, lower extremity > upper
Disconnection syndrome

Question 9

Middle cerebral artery

Answer 9

Contralateral hemiparesis and sensory loss, upper extremity > lower
Contralateral hemianopia
Aphasia (Wernicke’s)
Gaze abnormalities

Question 10

Posterior cerebral artery

Answer 10

Contralateral hemianopia with macular sparing

Disconnection syndrome

Question 11

Horner’s Syndrome

Answer 11

Contralateral: limb sensory loss

Question 12

Pontine lesion

Answer 12

VI nerve: horizontal gaze palsy
VII nerve
Contralateral hemiparesis