Stroke: Presentations

Question 1

Total anterior circulation syndrome features

Answer 1

All 3 of:
Hemiplegia +/-hemisensory loss
Homonymous hemianopia
Higher cerebral dysfunction (dysphsia, neglect)

Question 2

Partial anterior circulation syndromes features

Answer 2

2/3 of:
Hemiplegia +/-hemisensory loss
Homonymous hemianopia
Higher cerebral dysfunction (dysphsia, neglect)
OR: pure motor/sensory signs less severe than in lacunar syndrome

Question 3

Lacunar syndrome features

Answer 3

One of:
Pure motor stroke
Pure sensory stroke
Sensorimotor hemiparesis
Ataxic hemiparesis 
At least 2/3 areas (face, arm, leg) should be involved

Question 4

Posterior circulation syndrome features

Answer 4

One of:
Ipsilateral cranial nerve palsy with contralateral motor and/or sensory deficit
Bilateral motor and/or sensory deficit
Conjugate eye movement disorder
Cerebellar dysfunction
Isolated homonymous hemianopia visual field defect or cortical blindness

Question 5

Which stroke syndrome has the worst prognosis?

Answer 5

Total anterior circulation syndrome

Question 6

Occlusion of anterior cerebral artery presentation

Answer 6

Motor and sensory deficit in the contralateral lower limb (+/- shoulder)

Question 7

Occlusion of middle cerebral artery presentation

Answer 7

Motor and sensory deficit in the contralateral face and upper limb
Homonymous hemianopia
Speech difficulties
(Broca’s and Wernicke’s are both located in the territory of the MCA)

Question 8

Occlusion of posterior cerebral artery presentation

Answer 8

Homonymous hemianopia (w/macular sparing)
Visual problems