Stroke syndromes

Anterior Circulation

• Blood supply via internal carotid system
• Includes ACA and MCA

Anterior Cerebral Artery (ACA)

Signs and Symptoms:

• Contralateral sensory and motor symptoms in the lower extremity (sparing hands/face)
• Left sided lesion: akinetic mutism, transcortical motor aphasia
• Right sided lesion: Confusion, motor hemineglect

Middle Cerebral Artery (MCA)

Signs and Symptoms:

• Hemiparesis, facial plegia, sensory loss contralateral to affected cortex
• Motor deficits found more commonly in face and upper extremity than lower extremity
• Dominant hemisphere involved: aphasia
• Nondominant hemisphere involved: inattention, neglect, dysarthria without aphasia
• Homonymous hemianopsia and gaze preference toward side of infarct may also be seen

Posterior circulation

• Blood supply via the vertebral vertebral artery
• Branches include, Basilar artery, PCA and PICA

Signs and Symptoms:

• Crossed neuro deficits (i.e., ipsilateral CN deficits w/ contralateral motor weakness)
• Multiple, simultaneous complaints are the rule
• 5 Ds: Dizziness (Vertigo), Dysarthria, Dystaxia, Diplopia, Dysphagia
• Isolated events are not attributable to vertebral occlusive disease (e.g. isolated lightheadedness, vertigo, transient ALOC, drop attacks)

Basilar artery

Signs and Symptoms:

• Quadriplegia, coma, locked-in syndrome

Posterior Cerebral Artery (PCA)

Signs and Symptoms:

• Unilateral headache (most common presenting complaint)
• Visual field defects (contralateral homonymous hemianopsia, unilateral blindness)
• Motor function is typically minimally affected

Posteroinferior Cerebellar Artery (PICA)

Signs and Symptoms:

• Vertigo, gait instability, limb ataxia, Headache, dysarthria, Nausea and Vomitting, Cranial Nerve abnormalities

See Also

• Stroke (Main)
• Cerebellar Stroke