Stroke Presentations

Question 1

MCA Syndrome

Answer 1

• hemiplegia
• global aphasia
• brachial syndrome (weakness of UE)
• facial weakness and motor aphasia
• combo of sensory disturbance, motor weakness and motor aphasia

Question 2

Anterior Cerebral Artery (ACA) Syndrome

Answer 2

• uncommon
• occlusion may affect both hemispheres
• contralateral hemiparesis and sensory loss in the LE
• abulia (delay in verbal and motor response)
• akinetic mutism

Question 3

Internal Carotid Syndrome

Answer 3

• depends on how it was occluded

- could be asymptomatic if circle of willis is functioning correctly

Question 4

PCA syndrome

Answer 4

• Weber syndrome
• subthalamus, thalamus and ipsilateral cerebral peduncle and midbrain
• thalamic syndrome (abnormal sensation of pain, temp, proprioception and touch)
• sensations may be exaggerated and light pressure may be interpreted as painful
• apathy, amnesia
• disinhibition syndromes with personality changes, loss of self-activation, thalamic dementia
• hemiplegia
• ataxia
• cranial nerve III palsy
• hemiballismus

Question 5

Vertebral and PICA Syndrome

Answer 5

• ischemia is not always manifested because of collateral circulation
• lateral medulla and posteroinferior cerebellum
• vertigo, nausea, hoarseness, dysphagia
• ipsilateral ataxia, ptosis, impariement of sensation to ipsilateral face

Question 6

Basilar Artery syndrome

Answer 6

• brainstem, corticospinal tract, corticobulbar tract, medial and superior cerebellar peduncles, spinothalamic tracts and cranial nerve nuclei affected
• symptoms are unilateral involving sensory and motor aspects of cranial nerves

Question 7

Sup. Cerebellar Artery Syndrome

Answer 7

-severe ipsilateral cerebellar ataxia
-nausea
-vomiting
-dysarthria (slurring of speech)
dysmetria

Question 8

AICA Syndrome

Answer 8

• horner’s syndrome
• ipsilateral deafness
• facial weakness
• vertigo
• nausea and vomiting
• nystagmus
• ataxia

Question 9

Lacunar Syndrome

Answer 9

• found in basal ganglia, internal capsule, pons
• asymptomatic
• 20% of cases show slow, progressive s/s
• weakness of the face, dysarthria
• ataxia, clumsiness, weakness

Question 10

inferior division of MCA

Answer 10

-wernicke’s aphasia w/o weakness