Stroke Syndromes

Question 1

Cortex and Internal Capsule

Answer 1

Contralateral hemiplegia of face, UE and LE
Contralateral hemisensory loss
Homonymous hemianopsia

Impairment of Consciousness

Question 2

MCA syndrome

Answer 2

(Lesion in cortex and internal capsule)
Contralateral hemiplegia of face, UE and LE (although LE more spared)
Contralateral hemisensory loss
Homonymous hemianopsia

Question 3

PCA syndrome

Answer 3

(primary visual cortex, occipital lobe)
Contralateral sensory loss
Involuntary movements (choreoathetosis, tremor, hemiballismus)
Transient contralateral hemiparesis
Homonymous hemianopsia

Visual agnosia, memory deficits, dyslexia, central (thalamic) pain, Weber’s syndrome, CN III palsy

Question 4

Internal capsule, lesion in the posterior limb

Answer 4

Lacunar (pure motor) stroke
Contralateral hemiplegia UE, LE

No aphasia
Visual field deficits are rare

Question 5

Midbrain Lesion

Answer 5

Contralateral Hemiplegia

Contralateral CN III palsy

Question 6

Medial Inferior Pontine Syndrome

Answer 6

Ipsilateral:
Cerebella ataxia, nystagmus
Paralysis of conjugate gaze to the side of the lesion
Diploplia

Contralateral:
Hemiparesis UE, LE
Impaired sensation

Question 7

Lateral inferior pontine syndrome

Answer 7

Ipsilateral:
Cerebellar ataxia, nystagmus, vertigo
Facial paralysis
Paralysis of conjugate gaze to the side of the lesion
Deafness, tinnitus
Impaired facial sensation

Contralateral:
Impaired pain and temperature sensation

Question 8

Locked-in syndrome

Answer 8

Tetraplegia
Lower bulbar paralysis (CN V-XIII)
Anarthria
Preserved consciousness
Preserved eye movements and blinking

Question 9

Medial Medullary Syndrome

Answer 9

Ipsilateral:
Paralysis to half of tongue

Contralateral:
Hemiplegia UE/LE
Impaired sensation

Question 10

Lateral Medullary Syndrome (Wallenberg’s Syndrome)

Answer 10

Ipsilateral:
Cerebellar ataxia, nystagmus, vertigo
Loss of pain and temperature in the face
Sensory loss UE, trunk, LE

Contralateral:
Loss of pain and temperature of the face

Horner’s syndrome
Dysphagia
Impaired speech